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 $46.77 Median $169.82 Typical High $275.42 | Professional | None | $46.77 | $169.82 | $275.42 |
BCBS Tennessee Setting Facility Modifier None Typical Low $50.12 Median $125.89 Typical High $281.84 | Facility | None | $50.12 | $125.89 | $281.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $60.26 Median $154.88 Typical High $501.19 | Professional | None | $60.26 | $154.88 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,862.09 Typical High $2,691.53 | Facility | None | $645.65 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $151.36 Typical High $275.42 | Professional | None | $47.86 | $151.36 | $275.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,778.28 | $2,344.23 | $2,344.23 |
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 $48.98 Median $144.54 Typical High $331.13 | Professional | None | $48.98 | $144.54 | $331.13 |
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 $23.44 Median $61.66 Typical High $138.04 | Professional | 52 · Reduced service | $23.44 | $61.66 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $24.55 Typical High $54.95 | Professional | 53 · Discontinued | $9.33 | $24.55 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $91.20 Typical High $208.93 | Professional | 54 · Surgery only | $35.48 | $91.20 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $16.98 Typical High $41.69 | Professional | 55 · Aftercare only | $7.08 | $16.98 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $12.30 Typical High $27.54 | Professional | 56 · Pre-op care only | $4.68 | $12.30 | $27.54 |
Where Tennessee sits
The same service costs 4.6 times more in Iowa 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· 18th of 51
$186
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.