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 $114.82 Median $131.83 Typical High $1,348.96 | Professional | None | $114.82 | $131.83 | $1,348.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $5,128.61 | Facility | None | $933.25 | $1,905.46 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $275.42 | Professional | None | $128.82 | $169.82 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $2,238.72 Typical High $4,570.88 | Facility | None | $398.11 | $2,238.72 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $239.88 | Professional | None | $128.82 | $162.18 | $239.88 |
Lucent Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $8,709.64 | Facility | None | $1,202.26 | $3,801.89 | $8,709.64 |
United Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $275.42 | Professional | None | $112.20 | $177.83 | $275.42 |
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 $57.54 Median $61.66 Typical High $95.50 | Professional | 52 · Reduced service | $57.54 | $61.66 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $24.55 Typical High $38.02 | Professional | 53 · Discontinued | $22.91 | $24.55 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $91.20 Typical High $144.54 | Professional | 54 · Surgery only | $87.10 | $91.20 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.20 Typical High $28.84 | Professional | 55 · Aftercare only | $17.38 | $18.20 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.30 Typical High $19.05 | Professional | 56 · Pre-op care only | $11.48 | $12.30 | $19.05 |
Where Tennessee sits
The same service costs 12.9 times more in Arkansas 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· 7th of 51
$1,259
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.