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 $87.10 Median $186.21 Typical High $275.42 | Professional | None | $87.10 | $186.21 | $275.42 |
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 $93.33 Median $177.83 Typical High $295.12 | Professional | None | $93.33 | $177.83 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,659.59 Typical High $3,090.30 | Facility | None | $389.05 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $275.42 | Professional | None | $104.71 | $173.78 | $275.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,513.56 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $89.13 Median $173.78 Typical High $316.23 | Professional | None | $89.13 | $173.78 | $316.23 |
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 $43.65 Median $91.20 Typical High $138.04 | Professional | 52 · Reduced service | $43.65 | $91.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $37.15 Typical High $56.23 | Professional | 53 · Discontinued | $17.38 | $37.15 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $138.04 Typical High $208.93 | Professional | 54 · Surgery only | $64.57 | $138.04 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $27.54 Typical High $41.69 | Professional | 55 · Aftercare only | $12.88 | $27.54 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $18.62 Typical High $27.54 | Professional | 56 · Pre-op care only | $8.71 | $18.62 | $27.54 |
Where Tennessee sits
The same service costs 4.0 times more in Alaska than in Washington, DC. 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· 32nd of 51
$191
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.