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 $177.83 Median $186.21 Typical High $295.12 | Professional | None | $177.83 | $186.21 | $295.12 |
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 $204.17 Median $263.03 Typical High $436.52 | Professional | None | $204.17 | $263.03 | $436.52 |
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 $162.18 Median $245.47 Typical High $371.54 | Professional | None | $162.18 | $245.47 | $371.54 |
Lucent Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,479.11 | $1,479.11 |
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 $177.83 Median $288.40 Typical High $426.58 | Professional | None | $177.83 | $288.40 | $426.58 |
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 $89.13 Median $93.33 Typical High $147.91 | Professional | 52 · Reduced service | $89.13 | $93.33 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $37.15 Typical High $58.88 | Professional | 53 · Discontinued | $35.48 | $37.15 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $141.25 Typical High $218.78 | Professional | 54 · Surgery only | $131.83 | $141.25 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.18 Typical High $43.65 | Professional | 55 · Aftercare only | $26.30 | $28.18 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $18.62 Typical High $29.51 | Professional | 56 · Pre-op care only | $17.78 | $18.62 | $29.51 |
Where Tennessee sits
The same service costs 4.3 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· 3rd of 51
$708
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.