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 $794.33 Median $831.76 Typical High $1,445.44 | Professional | None | $794.33 | $831.76 | $1,445.44 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,949.84 | Professional | None | $912.01 | $1,202.26 | $1,949.84 |
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 $724.44 Median $1,096.48 Typical High $1,659.59 | Professional | None | $724.44 | $1,096.48 | $1,659.59 |
Lucent Health Setting Professional Modifier None Typical Low $5,623.41 Median $6,606.93 Typical High $6,606.93 | Professional | None | $5,623.41 | $6,606.93 | $6,606.93 |
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 $794.33 Median $1,288.25 Typical High $1,905.46 | Professional | None | $794.33 | $1,288.25 | $1,905.46 |
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 $398.11 Median $416.87 Typical High $660.69 | Professional | 52 · Reduced service | $398.11 | $416.87 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $165.96 Typical High $263.03 | Professional | 53 · Discontinued | $158.49 | $165.96 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $630.96 Typical High $1,000.00 | Professional | 54 · Surgery only | $588.84 | $630.96 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $125.89 Typical High $199.53 | Professional | 55 · Aftercare only | $120.23 | $125.89 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $83.18 Typical High $131.83 | Professional | 56 · Pre-op care only | $79.43 | $83.18 | $131.83 |
Where Tennessee sits
The same service costs 4.3 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
$1,288
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.