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 $1,698.24 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,698.24 | $1,819.70 | $2,818.38 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,584.89 Typical High $3,981.07 | Facility | None | $501.19 | $1,584.89 | $3,981.07 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,949.84 | $3,162.28 |
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 $1,659.59 Median $2,238.72 Typical High $3,235.94 | Professional | None | $1,659.59 | $2,238.72 | $3,235.94 |
Lucent Health Setting Professional Modifier None Typical Low $12,882.50 Median $14,125.38 Typical High $14,125.38 | Professional | None | $12,882.50 | $14,125.38 | $14,125.38 |
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 $1,445.44 Median $2,290.87 Typical High $3,388.44 | Professional | None | $1,445.44 | $2,290.87 | $3,388.44 |
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 $851.14 Median $891.25 Typical High $1,412.54 | Professional | 52 · Reduced service | $851.14 | $891.25 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $363.08 Typical High $562.34 | Professional | 53 · Discontinued | $338.84 | $363.08 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,348.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,288.25 | $1,348.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $269.15 Typical High $426.58 | Professional | 55 · Aftercare only | $257.04 | $269.15 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $181.97 Typical High $281.84 | Professional | 56 · Pre-op care only | $169.82 | $181.97 | $281.84 |
Where Tennessee sits
The same service costs 5.5 times more in Wisconsin than in South Carolina. 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· 38th of 51
$2,042
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.