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 $22.91 Median $45.71 Typical High $64.57 | Professional | None | $22.91 | $45.71 | $64.57 |
BCBS Tennessee Setting Facility Modifier None Typical Low $50.12 Median $138.04 Typical High $1,000.00 | Facility | None | $50.12 | $138.04 | $1,000.00 |
BCBS Tennessee Setting Professional Modifier None Typical Low $30.20 Median $53.70 Typical High $89.13 | Professional | None | $30.20 | $53.70 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $1,659.59 Typical High $2,691.53 | Facility | None | $52.48 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $47.86 Typical High $85.11 | Professional | None | $23.44 | $47.86 | $85.11 |
Lucent Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $28.18 Median $54.95 Typical High $93.33 | Professional | None | $28.18 | $54.95 | $93.33 |
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 $11.48 Median $16.98 Typical High $31.62 | Professional | 52 · Reduced service | $11.48 | $16.98 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $6.92 Typical High $12.59 | Professional | 53 · Discontinued | $4.57 | $6.92 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.98 Median $25.70 Typical High $46.77 | Professional | 54 · Surgery only | $16.98 | $25.70 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $5.13 Typical High $9.33 | Professional | 55 · Aftercare only | $3.39 | $5.13 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $3.47 Typical High $6.31 | Professional | 56 · Pre-op care only | $2.29 | $3.47 | $6.31 |
Where Tennessee sits
The same service costs 4.0 times more in Alaska than in Texas. 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· 11th of 51
$67.61
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.