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 $794.33 Median $2,290.87 Typical High $7,585.78 | Facility | None | $794.33 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $1,348.96 | Professional | None | $36.31 | $45.71 | $1,348.96 |
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 $43.65 Median $52.48 Typical High $75.86 | Professional | None | $43.65 | $52.48 | $75.86 |
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 $37.15 Median $44.67 Typical High $89.13 | Professional | None | $37.15 | $44.67 | $89.13 |
Lucent Health Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | None | $575.44 | $645.65 | $645.65 |
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 $43.65 Median $53.70 Typical High $100.00 | Professional | None | $43.65 | $53.70 | $100.00 |
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 $18.20 Median $18.62 Typical High $25.70 | Professional | 52 · Reduced service | $18.20 | $18.62 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.41 Typical High $10.23 | Professional | 53 · Discontinued | $7.24 | $7.41 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $28.18 Typical High $38.02 | Professional | 54 · Surgery only | $26.92 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.62 Typical High $7.59 | Professional | 55 · Aftercare only | $5.37 | $5.62 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.72 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.63 | $3.72 | $5.13 |
Where Tennessee sits
The same service costs 13.8 times more in Oklahoma than in New York. 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· 2nd of 51
$302
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.