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 $467.74 Median $501.19 Typical High $776.25 | Professional | None | $467.74 | $501.19 | $776.25 |
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 $537.03 Median $707.95 Typical High $1,148.15 | Professional | None | $537.03 | $707.95 | $1,148.15 |
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 $436.52 Median $660.69 Typical High $1,023.29 | Professional | None | $436.52 | $660.69 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,388.44 | $3,981.07 | $3,981.07 |
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 $467.74 Median $758.58 Typical High $1,148.15 | Professional | None | $467.74 | $758.58 | $1,148.15 |
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 $234.42 Median $251.19 Typical High $389.05 | Professional | 52 · Reduced service | $234.42 | $251.19 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $100.00 Typical High $158.49 | Professional | 53 · Discontinued | $93.33 | $100.00 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $371.54 Typical High $588.84 | Professional | 54 · Surgery only | $354.81 | $371.54 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $117.49 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $77.62 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $77.62 |
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· 10th of 51
$933
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.