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 $741.31 Median $794.33 Typical High $1,230.27 | Professional | None | $741.31 | $794.33 | $1,230.27 |
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 $851.14 Median $1,096.48 Typical High $1,819.70 | Professional | None | $851.14 | $1,096.48 | $1,819.70 |
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 $691.83 Median $1,047.13 Typical High $1,548.82 | Professional | None | $691.83 | $1,047.13 | $1,548.82 |
Lucent Health Setting Professional Modifier None Typical Low $5,370.32 Median $6,165.95 Typical High $6,165.95 | Professional | None | $5,370.32 | $6,165.95 | $6,165.95 |
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 $741.31 Median $1,148.15 Typical High $1,778.28 | Professional | None | $741.31 | $1,148.15 | $1,778.28 |
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 $371.54 Median $389.05 Typical High $616.60 | Professional | 52 · Reduced service | $371.54 | $389.05 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $245.47 | Professional | 53 · Discontinued | $147.91 | $158.49 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $933.25 | Professional | 54 · Surgery only | $562.34 | $588.84 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $117.49 Typical High $186.21 | Professional | 55 · Aftercare only | $112.20 | $117.49 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $123.03 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $123.03 |
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· 15th of 51
$1,230
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.