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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $549.54 Typical High $933.25 | Professional | None | $120.23 | $549.54 | $933.25 |
BCBS Tennessee Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $2,754.23 | Facility | None | $104.71 | $147.91 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $147.91 Median $457.09 Typical High $954.99 | Professional | None | $147.91 | $457.09 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $363.08 Typical High $912.01 | Professional | None | $112.20 | $363.08 | $912.01 |
Lucent Health Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,677.35 | Professional | None | $3,801.89 | $3,801.89 | $4,677.35 |
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 $123.03 Median $371.54 Typical High $1,047.13 | Professional | None | $123.03 | $371.54 | $1,047.13 |
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 $60.26 Median $190.55 Typical High $467.74 | Professional | 52 · Reduced service | $60.26 | $190.55 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $75.86 Typical High $186.21 | Professional | 53 · Discontinued | $23.99 | $75.86 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $281.84 Typical High $707.95 | Professional | 54 · Surgery only | $91.20 | $281.84 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $56.23 Typical High $141.25 | Professional | 55 · Aftercare only | $18.20 | $56.23 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $38.02 Typical High $93.33 | Professional | 56 · Pre-op care only | $12.02 | $38.02 | $93.33 |
Where Tennessee sits
The same service costs 4.0 times more in Wisconsin than in Maryland. 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· 14th of 51
$550
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.