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 $39.81 Median $45.71 Typical High $1,348.96 | Professional | None | $39.81 | $45.71 | $1,348.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $95.50 | Professional | None | $44.67 | $57.54 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $81.28 | Professional | None | $42.66 | $53.70 | $81.28 |
Lucent Health Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $954.99 | Professional | None | $616.60 | $954.99 | $954.99 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $38.90 Median $60.26 Typical High $95.50 | Professional | None | $38.90 | $60.26 | $95.50 |
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 $19.95 Median $20.89 Typical High $33.11 | Professional | 52 · Reduced service | $19.95 | $20.89 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.32 Typical High $13.18 | Professional | 53 · Discontinued | $7.94 | $8.32 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $31.62 Typical High $50.12 | Professional | 54 · Surgery only | $29.51 | $31.62 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.31 Typical High $10.00 | Professional | 55 · Aftercare only | $6.03 | $6.31 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.17 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.98 | $4.17 | $6.61 |
Where Tennessee sits
The same service costs 9.3 times more in Tennessee than in New York. 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· 1st of 51
$398
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.