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 $120.23 Median $131.83 Typical High $199.53 | Professional | None | $120.23 | $131.83 | $199.53 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $257.04 | Professional | None | $117.49 | $147.91 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $407.38 Typical High $1,659.59 | Facility | None | $275.42 | $407.38 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $208.93 | Professional | None | $125.89 | $128.82 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $109.65 Median $144.54 Typical High $263.03 | Professional | None | $109.65 | $144.54 | $263.03 |
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 $64.57 Typical High $100.00 | Professional | 52 · Reduced service | $60.26 | $64.57 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.70 Typical High $39.81 | Professional | 53 · Discontinued | $23.99 | $25.70 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $95.50 Typical High $151.36 | Professional | 54 · Surgery only | $91.20 | $95.50 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $30.20 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.88 Typical High $19.95 | Professional | 56 · Pre-op care only | $12.02 | $12.88 | $19.95 |
Where Tennessee sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 32nd of 51
$158
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.