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 $1,122.02 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,122.02 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $1,071.52 Typical High $1,862.09 | Professional | None | $263.03 | $1,071.52 | $1,862.09 |
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 $316.23 Median $977.24 Typical High $2,137.96 | Professional | None | $316.23 | $977.24 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $758.58 Typical High $1,905.46 | Professional | None | $245.47 | $758.58 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $9,332.54 | Professional | None | $7,244.36 | $7,244.36 | $9,332.54 |
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 $263.03 Median $812.83 Typical High $2,238.72 | Professional | None | $263.03 | $812.83 | $2,238.72 |
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 $131.83 Median $407.38 Typical High $891.25 | Professional | 52 · Reduced service | $131.83 | $407.38 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $162.18 Typical High $354.81 | Professional | 53 · Discontinued | $52.48 | $162.18 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $602.56 Typical High $1,348.96 | Professional | 54 · Surgery only | $194.98 | $602.56 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $120.23 Typical High $269.15 | Professional | 55 · Aftercare only | $38.90 | $120.23 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $81.28 Typical High $177.83 | Professional | 56 · Pre-op care only | $26.30 | $81.28 | $177.83 |
Where Tennessee sits
The same service costs 3.5 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· 17th of 51
$1,122
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.