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 $158.49 Median $251.19 Typical High $363.08 | Professional | None | $158.49 | $251.19 | $363.08 |
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 $190.55 Median $323.59 Typical High $660.69 | Professional | None | $190.55 | $323.59 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $181.97 Typical High $346.74 | Facility | None | $50.12 | $181.97 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $446.68 | Professional | None | $165.96 | $275.42 | $446.68 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,951.21 | Professional | None | $2,238.72 | $2,238.72 | $2,951.21 |
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 $162.18 Median $257.04 Typical High $478.63 | Professional | None | $162.18 | $257.04 | $478.63 |
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 $79.43 Median $125.89 Typical High $177.83 | Professional | 52 · Reduced service | $79.43 | $125.89 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $50.12 Typical High $72.44 | Professional | 53 · Discontinued | $31.62 | $50.12 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $186.21 Typical High $269.15 | Professional | 54 · Surgery only | $117.49 | $186.21 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $37.15 Typical High $53.70 | Professional | 55 · Aftercare only | $23.44 | $37.15 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $25.12 Typical High $36.31 | Professional | 56 · Pre-op care only | $15.85 | $25.12 | $36.31 |
Where Tennessee sits
The same service costs 4.0 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· 17th of 51
$324
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.