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 $1,479.11 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,479.11 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $380.19 | Professional | None | $229.09 | $331.13 | $380.19 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,089.30 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $831.76 | Professional | None | $323.59 | $489.78 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,951.21 Typical High $6,760.83 | Facility | None | $588.84 | $2,951.21 | $6,760.83 |
Lucent Health Setting Professional Modifier None Typical Low $2,818.38 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,818.38 | $3,715.35 | $3,715.35 |
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 $302.00 Median $426.58 Typical High $776.25 | Professional | None | $302.00 | $426.58 | $776.25 |
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 $114.82 Median $162.18 Typical High $173.78 | Professional | 52 · Reduced service | $114.82 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $64.57 Typical High $69.18 | Professional | 53 · Discontinued | $45.71 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $245.47 Typical High $263.03 | Professional | 54 · Surgery only | $173.78 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $48.98 Typical High $52.48 | Professional | 55 · Aftercare only | $34.67 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $32.36 Typical High $34.67 | Professional | 56 · Pre-op care only | $22.91 | $32.36 | $34.67 |
Where Tennessee sits
The same service costs 28.2 times more in Texas than in Kentucky. 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· 7th of 51
$794
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.