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 $89.13 Median $436.52 Typical High $724.44 | Professional | None | $89.13 | $436.52 | $724.44 |
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 $109.65 Median $323.59 Typical High $776.25 | Professional | None | $109.65 | $323.59 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $676.08 Typical High $2,691.53 | Facility | None | $398.11 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $257.04 Typical High $691.83 | Professional | None | $87.10 | $257.04 | $691.83 |
Lucent Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,630.27 | $3,162.28 | $3,162.28 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,884.03 | Facility | None | $346.74 | $1,047.13 | $2,884.03 |
United Setting Professional Modifier None Typical Low $97.72 Median $371.54 Typical High $831.76 | Professional | None | $97.72 | $371.54 | $831.76 |
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 $44.67 Median $74.13 Typical High $363.08 | Professional | 52 · Reduced service | $44.67 | $74.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $30.20 Typical High $144.54 | Professional | 53 · Discontinued | $18.20 | $30.20 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $112.20 Typical High $549.54 | Professional | 54 · Surgery only | $67.61 | $112.20 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $22.39 Typical High $109.65 | Professional | 55 · Aftercare only | $13.49 | $22.39 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $15.14 Typical High $72.44 | Professional | 56 · Pre-op care only | $8.91 | $15.14 | $72.44 |
Where Tennessee sits
The same service costs 7.8 times more in Oklahoma 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· 7th of 51
$575
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.