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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,174.90 | Professional | None | $707.95 | $758.58 | $1,174.90 |
BCBS Tennessee Setting Facility Modifier None Typical Low $50.12 Median $125.89 Typical High $208.93 | Facility | None | $50.12 | $125.89 | $208.93 |
BCBS Tennessee Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,698.24 | Professional | None | $812.83 | $1,047.13 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,047.13 Typical High $2,691.53 | Facility | None | $562.34 | $1,047.13 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,479.11 | Professional | None | $660.69 | $977.24 | $1,479.11 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,128.61 | $5,888.44 | $5,888.44 |
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 $707.95 Median $1,122.02 Typical High $1,698.24 | Professional | None | $707.95 | $1,122.02 | $1,698.24 |
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 $354.81 Median $371.54 Typical High $588.84 | Professional | 52 · Reduced service | $354.81 | $371.54 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $151.36 Typical High $234.42 | Professional | 53 · Discontinued | $141.25 | $151.36 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $891.25 | Professional | 54 · Surgery only | $537.03 | $562.34 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $177.83 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $75.86 Typical High $117.49 | Professional | 56 · Pre-op care only | $70.79 | $75.86 | $117.49 |
Where Tennessee sits
The same service costs 3.8 times more in Wisconsin 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· 34th of 51
$1,000
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.