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 $2,630.27 Median $6,606.93 Typical High $14,454.40 | Facility | None | $2,630.27 | $6,606.93 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $4,570.88 | Professional | None | $831.76 | $1,202.26 | $4,570.88 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,862.09 Median $3,981.07 Typical High $8,511.38 | Facility | None | $1,862.09 | $3,981.07 | $8,511.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,479.11 | $1,905.46 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,011.87 Typical High $10,232.93 | Facility | None | $602.56 | $5,011.87 | $10,232.93 |
Lucent Health Setting Professional Modifier None Typical Low $12,882.50 Median $15,848.93 Typical High $15,848.93 | Professional | None | $12,882.50 | $15,848.93 | $15,848.93 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,230.27 | $1,949.84 | $3,388.44 |
4 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 $416.87 Median $478.63 Typical High $588.84 | Professional | 52 · Reduced service | $416.87 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $190.55 Typical High $239.88 | Professional | 53 · Discontinued | $165.96 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $141.25 Typical High $177.83 | Professional | 55 · Aftercare only | $125.89 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $95.50 Typical High $120.23 | Professional | 56 · Pre-op care only | $83.18 | $95.50 | $120.23 |
Where Tennessee sits
The same service costs 9.1 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
$3,802
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.