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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $120.23 Typical High $169.82 | Professional | None | $56.23 | $120.23 | $169.82 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $75.86 Median $131.83 Typical High $223.87 | Professional | None | $75.86 | $131.83 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $125.89 Typical High $213.80 | Professional | None | $58.88 | $125.89 | $213.80 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,096.48 | $1,258.93 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $234.42 | Professional | None | $69.18 | $128.82 | $234.42 |
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 $28.18 Median $42.66 Typical High $83.18 | Professional | 52 · Reduced service | $28.18 | $42.66 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $16.98 Typical High $33.11 | Professional | 53 · Discontinued | $11.22 | $16.98 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $63.10 Typical High $123.03 | Professional | 54 · Surgery only | $41.69 | $63.10 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.59 Typical High $24.55 | Professional | 55 · Aftercare only | $8.32 | $12.59 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.51 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.62 | $8.51 | $16.60 |
Where Tennessee sits
The same service costs 3.5 times more in Alaska 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· 12th of 51
$166
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.