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 $1,621.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,621.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $2,089.30 | Professional | None | $128.82 | $151.36 | $2,089.30 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,318.26 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $316.23 | Professional | None | $147.91 | $194.98 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,467.37 Typical High $7,079.46 | Facility | None | $616.60 | $3,467.37 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $288.40 | Professional | None | $141.25 | $186.21 | $288.40 |
Lucent Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $13,803.84 | Facility | None | $1,778.28 | $6,025.60 | $13,803.84 |
United Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $309.03 | Professional | None | $131.83 | $208.93 | $309.03 |
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 $64.57 Median $67.61 Typical High $107.15 | Professional | 52 · Reduced service | $64.57 | $67.61 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.92 Typical High $42.66 | Professional | 53 · Discontinued | $25.70 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $102.33 Typical High $158.49 | Professional | 54 · Surgery only | $95.50 | $102.33 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.42 Typical High $32.36 | Professional | 55 · Aftercare only | $19.05 | $20.42 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.88 | $13.49 | $21.38 |
Where Tennessee sits
The same service costs 17.8 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· 3rd of 51
$2,138
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.