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 $2,454.71 Median $4,168.69 Typical High $7,585.78 | Facility | None | $2,454.71 | $4,168.69 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $2,818.38 | Professional | None | $524.81 | $602.56 | $2,818.38 |
BCBS Tennessee Setting Facility Modifier None Typical Low $3,801.89 Median $8,317.64 Typical High $14,125.38 | Facility | None | $3,801.89 | $8,317.64 | $14,125.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,819.70 | Professional | None | $851.14 | $1,122.02 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $21,877.62 Typical High $45,708.82 | Facility | None | $588.84 | $21,877.62 | $45,708.82 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
United Setting Facility Modifier None Typical Low $8,912.51 Median $18,620.87 Typical High $40,738.03 | Facility | None | $8,912.51 | $18,620.87 | $40,738.03 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,698.24 | Professional | None | $776.25 | $1,174.90 | $1,698.24 |
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 $263.03 Median $302.00 Typical High $371.54 | Professional | 52 · Reduced service | $263.03 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $120.23 Typical High $151.36 | Professional | 53 · Discontinued | $104.71 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $446.68 Typical High $562.34 | Professional | 54 · Surgery only | $389.05 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $112.20 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $60.26 Typical High $74.13 | Professional | 56 · Pre-op care only | $52.48 | $60.26 | $74.13 |
Where Tennessee sits
The same service costs 50.1 times more in Arkansas 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· 8th of 51
$6,026
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.