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 $79.43 Median $190.55 Typical High $288.40 | Professional | None | $79.43 | $190.55 | $288.40 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $87.10 Median $169.82 Typical High $288.40 | Professional | None | $87.10 | $169.82 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $1,659.59 | Facility | None | $389.05 | $831.76 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $177.83 Typical High $275.42 | Professional | None | $93.33 | $177.83 | $275.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,479.11 | $2,041.74 |
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 $85.11 Median $177.83 Typical High $309.03 | Professional | None | $85.11 | $177.83 | $309.03 |
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 $39.81 Median $89.13 Typical High $144.54 | Professional | 52 · Reduced service | $39.81 | $89.13 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $35.48 Typical High $57.54 | Professional | 53 · Discontinued | $15.85 | $35.48 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $134.90 Typical High $213.80 | Professional | 54 · Surgery only | $58.88 | $134.90 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $26.92 Typical High $42.66 | Professional | 55 · Aftercare only | $11.75 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $17.78 Typical High $28.84 | Professional | 56 · Pre-op care only | $7.94 | $17.78 | $28.84 |
Where Tennessee sits
The same service costs 4.2 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· 25th of 51
$195
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.