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 $100.00 Median $199.53 Typical High $302.00 | Professional | None | $100.00 | $199.53 | $302.00 |
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 $109.65 Median $194.98 Typical High $323.59 | Professional | None | $109.65 | $194.98 | $323.59 |
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 $117.49 Median $194.98 Typical High $288.40 | Professional | None | $117.49 | $194.98 | $288.40 |
Lucent Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,548.82 | $1,548.82 | $2,089.30 |
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 $186.21 Typical High $338.84 | Professional | None | $107.15 | $186.21 | $338.84 |
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 $50.12 Median $100.00 Typical High $151.36 | Professional | 52 · Reduced service | $50.12 | $100.00 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $39.81 Typical High $60.26 | Professional | 53 · Discontinued | $19.95 | $39.81 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $147.91 Typical High $223.87 | Professional | 54 · Surgery only | $74.13 | $147.91 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $29.51 Typical High $44.67 | Professional | 55 · Aftercare only | $14.79 | $29.51 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $19.95 Typical High $30.20 | Professional | 56 · Pre-op care only | $10.00 | $19.95 | $30.20 |
Where Tennessee sits
The same service costs 3.8 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· 27th of 51
$209
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.