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 $954.99 Median $2,290.87 Typical High $7,585.78 | Facility | None | $954.99 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $3,235.94 | Professional | None | $2,238.72 | $2,570.40 | $3,235.94 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $8,128.31 | Professional | None | $3,467.37 | $4,677.35 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $954.99 Typical High $5,248.07 | Facility | None | $588.84 | $954.99 | $5,248.07 |
Lucent Health Setting Professional Modifier None Typical Low $21,877.62 Median $22,908.68 Typical High $22,908.68 | Professional | None | $21,877.62 | $22,908.68 | $22,908.68 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $3,388.44 Median $4,897.79 Typical High $7,585.78 | Professional | None | $3,388.44 | $4,897.79 | $7,585.78 |
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 $1,122.02 Median $1,288.25 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,122.02 | $1,288.25 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $512.86 Typical High $645.65 | Professional | 53 · Discontinued | $457.09 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,949.84 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,698.24 | $1,949.84 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $389.05 Typical High $489.78 | Professional | 55 · Aftercare only | $338.84 | $389.05 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $257.04 Typical High $323.59 | Professional | 56 · Pre-op care only | $223.87 | $257.04 | $323.59 |
Where Tennessee sits
The same service costs 3.5 times more in Indiana than in Maryland. 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· 38th of 51
$2,570
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.