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 $2,344.23 Median $4,265.80 Typical High $7,585.78 | Facility | None | $2,344.23 | $4,265.80 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $2,818.38 | Professional | None | $389.05 | $446.68 | $2,818.38 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,584.89 Median $7,413.10 Typical High $14,125.38 | Facility | None | $1,584.89 | $7,413.10 | $14,125.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,348.96 | Professional | None | $645.65 | $831.76 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $15,488.17 Typical High $32,359.37 | Facility | None | $588.84 | $15,488.17 | $32,359.37 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $3,801.89 | Professional | None | $2,951.21 | $3,801.89 | $3,801.89 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $10,000.00 Typical High $15,848.93 | Facility | None | $3,630.78 | $10,000.00 | $15,848.93 |
United Setting Professional Modifier None Typical Low $575.44 Median $912.01 Typical High $1,318.26 | Professional | None | $575.44 | $912.01 | $1,318.26 |
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 $194.98 Median $223.87 Typical High $281.84 | Professional | 52 · Reduced service | $194.98 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $89.13 Typical High $112.20 | Professional | 53 · Discontinued | $77.62 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $295.12 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $58.88 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $44.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $38.90 | $44.67 | $56.23 |
Where Tennessee sits
The same service costs 27.5 times more in Oklahoma than in New York. 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· 9th of 51
$4,074
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.