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 $223.87 Median $234.42 Typical High $371.54 | Professional | None | $223.87 | $234.42 | $371.54 |
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 $257.04 Median $338.84 Typical High $549.54 | Professional | None | $257.04 | $338.84 | $549.54 |
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 $208.93 Median $309.03 Typical High $467.74 | Professional | None | $208.93 | $309.03 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,905.46 | $1,905.46 |
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 $223.87 Median $363.08 Typical High $537.03 | Professional | None | $223.87 | $363.08 | $537.03 |
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 $112.20 Median $117.49 Typical High $186.21 | Professional | 52 · Reduced service | $112.20 | $117.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $47.86 Typical High $74.13 | Professional | 53 · Discontinued | $44.67 | $47.86 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $177.83 Typical High $281.84 | Professional | 54 · Surgery only | $169.82 | $177.83 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $35.48 Typical High $56.23 | Professional | 55 · Aftercare only | $33.88 | $35.48 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.44 Typical High $37.15 | Professional | 56 · Pre-op care only | $22.39 | $23.44 | $37.15 |
Where Tennessee sits
The same service costs 4.0 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· 4th 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.