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 $446.68 Median $467.74 Typical High $741.31 | Professional | None | $446.68 | $467.74 | $741.31 |
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 $512.86 Median $676.08 Typical High $1,096.48 | Professional | None | $512.86 | $676.08 | $1,096.48 |
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 $416.87 Median $616.60 Typical High $977.24 | Professional | None | $416.87 | $616.60 | $977.24 |
Lucent Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,235.94 | $3,715.35 | $3,715.35 |
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 $446.68 Median $724.44 Typical High $1,096.48 | Professional | None | $446.68 | $724.44 | $1,096.48 |
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 $223.87 Median $234.42 Typical High $371.54 | Professional | 52 · Reduced service | $223.87 | $234.42 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $95.50 Typical High $147.91 | Professional | 53 · Discontinued | $89.13 | $95.50 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $354.81 Typical High $562.34 | Professional | 54 · Surgery only | $338.84 | $354.81 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $70.79 Typical High $112.20 | Professional | 55 · Aftercare only | $67.61 | $70.79 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $74.13 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $74.13 |
Where Tennessee sits
The same service costs 3.9 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· 9th of 51
$912
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.