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 $1,621.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,621.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $194.98 Typical High $338.84 | Professional | None | $186.21 | $194.98 | $338.84 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,122.02 Median $3,090.30 Typical High $8,317.64 | Facility | None | $1,122.02 | $3,090.30 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $524.81 | Professional | None | $223.87 | $302.00 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,168.69 Typical High $7,585.78 | Facility | None | $707.95 | $4,168.69 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $446.68 | Professional | None | $186.21 | $251.19 | $446.68 |
Lucent Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,445.44 | $1,479.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $467.74 | Professional | None | $204.17 | $323.59 | $467.74 |
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 $93.33 Median $97.72 Typical High $147.91 | Professional | 52 · Reduced service | $93.33 | $97.72 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.90 Typical High $58.88 | Professional | 53 · Discontinued | $37.15 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $144.54 Typical High $218.78 | Professional | 54 · Surgery only | $141.25 | $144.54 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $29.51 Typical High $44.67 | Professional | 55 · Aftercare only | $28.18 | $29.51 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.50 Typical High $29.51 | Professional | 56 · Pre-op care only | $18.62 | $19.50 | $29.51 |
Where Tennessee sits
The same service costs 6.9 times more in Tennessee 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· 1st of 51
$1,413
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.