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 $251.19 Median $1,288.25 Typical High $2,238.72 | Professional | None | $251.19 | $1,288.25 | $2,238.72 |
BCBS Tennessee Setting Facility Modifier None Typical Low $2,511.89 Median $4,168.69 Typical High $6,456.54 | Facility | None | $2,511.89 | $4,168.69 | $6,456.54 |
BCBS Tennessee Setting Professional Modifier None Typical Low $309.03 Median $1,202.26 Typical High $2,511.89 | Professional | None | $309.03 | $1,202.26 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $794.33 Typical High $2,344.23 | Professional | None | $229.09 | $794.33 | $2,344.23 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $10,715.19 Typical High $10,715.19 | Professional | None | $8,709.64 | $10,715.19 | $10,715.19 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $4,677.35 Typical High $7,244.36 | Facility | None | $3,090.30 | $4,677.35 | $7,244.36 |
United Setting Professional Modifier None Typical Low $257.04 Median $1,258.93 Typical High $2,754.23 | Professional | None | $257.04 | $1,258.93 | $2,754.23 |
6 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 $125.89 Median $575.44 Typical High $1,071.52 | Professional | 52 · Reduced service | $125.89 | $575.44 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $229.09 Typical High $426.58 | Professional | 53 · Discontinued | $50.12 | $229.09 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $870.96 Typical High $1,621.81 | Professional | 54 · Surgery only | $186.21 | $870.96 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $173.78 Typical High $316.23 | Professional | 55 · Aftercare only | $37.15 | $173.78 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $114.82 Typical High $213.80 | Professional | 56 · Pre-op care only | $25.12 | $114.82 | $213.80 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | XU · Unusual separate service | $263.03 | $263.03 | $263.03 |
Where Tennessee sits
The same service costs 4.7 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· 14th of 51
$1,445
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.