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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $549.54 Typical High $954.99 | Professional | None | $147.91 | $549.54 | $954.99 |
BCBS Tennessee Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $3,801.89 | Facility | None | $104.71 | $147.91 | $3,801.89 |
BCBS Tennessee Setting Professional Modifier None Typical Low $177.83 Median $501.19 Typical High $977.24 | Professional | None | $177.83 | $501.19 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $380.19 Typical High $891.25 | Professional | None | $134.90 | $380.19 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,466.84 | Professional | None | $3,715.35 | $3,715.35 | $4,466.84 |
United Setting Facility Modifier None Typical Low $302.00 Median $741.31 Typical High $2,570.40 | Facility | None | $302.00 | $741.31 | $2,570.40 |
United Setting Professional Modifier None Typical Low $147.91 Median $416.87 Typical High $1,023.29 | Professional | None | $147.91 | $416.87 | $1,023.29 |
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 $74.13 Median $208.93 Typical High $457.09 | Professional | 52 · Reduced service | $74.13 | $208.93 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $83.18 Typical High $181.97 | Professional | 53 · Discontinued | $30.20 | $83.18 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $309.03 Typical High $691.83 | Professional | 54 · Surgery only | $112.20 | $309.03 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $61.66 Typical High $138.04 | Professional | 55 · Aftercare only | $22.39 | $61.66 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $41.69 Typical High $91.20 | Professional | 56 · Pre-op care only | $14.79 | $41.69 | $91.20 |
Where Tennessee sits
The same service costs 3.5 times more in Wisconsin than in Nebraska. 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· 17th of 51
$537
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.