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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $446.68 | Professional | None | $245.47 | $257.04 | $446.68 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $954.99 | Professional | None | $363.08 | $562.34 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $602.56 Typical High $1,659.59 | Facility | None | $436.52 | $602.56 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $812.83 | Professional | None | $331.13 | $371.54 | $812.83 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,951.21 | $2,951.21 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $812.83 | Professional | None | $288.40 | $512.86 | $812.83 |
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 $123.03 Median $128.82 Typical High $173.78 | Professional | 52 · Reduced service | $123.03 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $51.29 Typical High $69.18 | Professional | 53 · Discontinued | $48.98 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $263.03 | Professional | 54 · Surgery only | $186.21 | $190.55 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $52.48 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.70 Typical High $34.67 | Professional | 56 · Pre-op care only | $24.55 | $25.70 | $34.67 |
Where Tennessee sits
The same service costs 4.1 times more in Alaska 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· 12th of 51
$631
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.