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 $74.13 Median $186.21 Typical High $281.84 | Professional | None | $74.13 | $186.21 | $281.84 |
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 $81.28 Median $162.18 Typical High $275.42 | Professional | None | $81.28 | $162.18 | $275.42 |
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 $89.13 Median $147.91 Typical High $257.04 | Professional | None | $89.13 | $147.91 | $257.04 |
Lucent Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,445.44 | $1,995.26 |
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 $79.43 Median $147.91 Typical High $288.40 | Professional | None | $79.43 | $147.91 | $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 $37.15 Median $83.18 Typical High $138.04 | Professional | 52 · Reduced service | $37.15 | $83.18 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $33.88 Typical High $56.23 | Professional | 53 · Discontinued | $14.79 | $33.88 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $123.03 Typical High $208.93 | Professional | 54 · Surgery only | $56.23 | $123.03 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $25.12 Typical High $41.69 | Professional | 55 · Aftercare only | $11.22 | $25.12 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $16.60 Typical High $27.54 | Professional | 56 · Pre-op care only | $7.41 | $16.60 | $27.54 |
Where Tennessee sits
The same service costs 4.5 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· 24th of 51
$186
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.