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 $70.79 Median $74.13 Typical High $134.90 | Professional | None | $70.79 | $74.13 | $134.90 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,230.27 Typical High $3,235.94 | Facility | None | $501.19 | $1,230.27 | $3,235.94 |
BCBS Tennessee Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $194.98 | Professional | None | $85.11 | $114.82 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $190.55 | Professional | None | $74.13 | $100.00 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $181.97 | Professional | None | $75.86 | $125.89 | $181.97 |
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 $35.48 Median $37.15 Typical High $56.23 | Professional | 52 · Reduced service | $35.48 | $37.15 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.79 Typical High $22.39 | Professional | 53 · Discontinued | $14.13 | $14.79 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $54.95 Typical High $83.18 | Professional | 54 · Surgery only | $52.48 | $54.95 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.96 Typical High $16.60 | Professional | 55 · Aftercare only | $10.72 | $10.96 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.41 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.08 | $7.41 | $11.22 |
Where Tennessee sits
The same service costs 6.5 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
$513
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.