How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,621.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,621.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,412.54 | $2,089.30 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $2,089.30 Median $2,691.53 Typical High $4,466.84 | Professional | None | $2,089.30 | $2,691.53 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,570.40 Typical High $4,677.35 | Facility | None | $588.84 | $2,570.40 | $4,677.35 |
Lucent Health Setting Professional Modifier None Typical Low $11,481.54 Median $14,125.38 Typical High $14,125.38 | Professional | None | $11,481.54 | $14,125.38 | $14,125.38 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,818.38 Typical High $4,073.80 | Professional | None | $1,819.70 | $2,818.38 | $4,073.80 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $707.95 Typical High $870.96 | Professional | 52 · Reduced service | $616.60 | $707.95 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $281.84 Typical High $346.74 | Professional | 53 · Discontinued | $245.47 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,047.13 Typical High $1,318.26 | Professional | 54 · Surgery only | $912.01 | $1,047.13 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $208.93 Typical High $263.03 | Professional | 55 · Aftercare only | $181.97 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $141.25 Typical High $173.78 | Professional | 56 · Pre-op care only | $123.03 | $141.25 | $173.78 |
Where Tennessee sits
The same service costs 15.8 times more in Wisconsin than in Nebraska. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Tennessee· 17th of 51
$2,692
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.