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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $239.88 Typical High $371.54 | Professional | None | $123.03 | $239.88 | $371.54 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $537.03 | Professional | None | $151.36 | $281.84 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $478.63 Typical High $2,187.76 | Facility | None | $245.47 | $478.63 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $251.19 Typical High $436.52 | Professional | None | $125.89 | $251.19 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,949.84 | $1,949.84 | $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 $131.83 Median $257.04 Typical High $512.86 | Professional | None | $131.83 | $257.04 | $512.86 |
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 $58.88 Median $112.20 Typical High $162.18 | Professional | 52 · Reduced service | $58.88 | $112.20 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $45.71 Typical High $64.57 | Professional | 53 · Discontinued | $23.44 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $169.82 Typical High $245.47 | Professional | 54 · Surgery only | $89.13 | $169.82 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $33.88 Typical High $48.98 | Professional | 55 · Aftercare only | $17.78 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $22.91 Typical High $32.36 | Professional | 56 · Pre-op care only | $11.75 | $22.91 | $32.36 |
Where Tennessee sits
The same service costs 3.2 times more in Wisconsin 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· 16th 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.