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 $109.65 Median $120.23 Typical High $169.82 | Professional | None | $109.65 | $120.23 | $169.82 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $2,630.27 | Facility | None | $524.81 | $1,148.15 | $2,630.27 |
BCBS Tennessee Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $245.47 | Professional | None | $112.20 | $134.90 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $2,691.53 | Facility | None | $588.84 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $114.82 Typical High $204.17 | Professional | None | $112.20 | $114.82 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,023.29 | Professional | None | $870.96 | $870.96 | $1,023.29 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $251.19 | Professional | None | $107.15 | $128.82 | $251.19 |
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 $54.95 Median $60.26 Typical High $83.18 | Professional | 52 · Reduced service | $54.95 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $23.44 Typical High $33.11 | Professional | 53 · Discontinued | $21.88 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $89.13 Typical High $125.89 | Professional | 54 · Surgery only | $83.18 | $89.13 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.78 Typical High $25.12 | Professional | 55 · Aftercare only | $16.60 | $17.78 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.75 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.96 | $11.75 | $16.60 |
Where Tennessee sits
The same service costs 6.0 times more in Alaska than in Kentucky. 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· 21st of 51
$162
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.