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 $107.15 Median $120.23 Typical High $2,818.38 | Professional | None | $107.15 | $120.23 | $2,818.38 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $2,951.21 | Facility | None | $1,348.96 | $2,137.96 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,344.23 Typical High $3,890.45 | Facility | None | $1,288.25 | $2,344.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $288.40 | Professional | None | $112.20 | $177.83 | $288.40 |
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 $53.70 Median $57.54 Typical High $77.62 | Professional | 52 · Reduced service | $53.70 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.91 Typical High $30.90 | Professional | 53 · Discontinued | $21.88 | $22.91 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $85.11 Typical High $117.49 | Professional | 54 · Surgery only | $81.28 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.98 Typical High $23.44 | Professional | 55 · Aftercare only | $16.22 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $15.49 |
Where Tennessee sits
The same service costs 37.2 times more in Oklahoma 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· 6th of 51
$2,042
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.