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 $1,380.38 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,380.38 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $1,318.26 Typical High $2,187.76 | Professional | None | $323.59 | $1,318.26 | $2,187.76 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,089.30 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $436.52 Median $1,174.90 Typical High $2,818.38 | Professional | None | $436.52 | $1,174.90 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,630.27 Typical High $4,786.30 | Facility | None | $588.84 | $2,630.27 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $912.01 Typical High $2,454.71 | Professional | None | $302.00 | $912.01 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $10,471.29 Typical High $10,471.29 | Professional | None | $8,709.64 | $10,471.29 | $10,471.29 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,230.27 Typical High $2,818.38 | Professional | None | $380.19 | $1,230.27 | $2,818.38 |
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 $162.18 Median $302.00 Typical High $1,096.48 | Professional | 52 · Reduced service | $162.18 | $302.00 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $120.23 Typical High $436.52 | Professional | 53 · Discontinued | $66.07 | $120.23 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $457.09 Typical High $1,621.81 | Professional | 54 · Surgery only | $245.47 | $457.09 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $91.20 Typical High $323.59 | Professional | 55 · Aftercare only | $48.98 | $91.20 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $60.26 Typical High $218.78 | Professional | 56 · Pre-op care only | $32.36 | $60.26 | $218.78 |
Where Tennessee sits
The same service costs 5.1 times more in Alaska 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· 12th of 51
$1,862
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.