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 $35.48 Median $144.54 Typical High $229.09 | Professional | None | $35.48 | $144.54 | $229.09 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $38.90 Median $125.89 Typical High $234.42 | Professional | None | $38.90 | $125.89 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $117.49 Typical High $204.17 | Professional | None | $43.65 | $117.49 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,122.02 | $1,479.11 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $38.02 Median $97.72 Typical High $229.09 | Professional | None | $38.02 | $97.72 | $229.09 |
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 $17.78 Median $48.98 Typical High $112.20 | Professional | 52 · Reduced service | $17.78 | $48.98 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $19.95 Typical High $45.71 | Professional | 53 · Discontinued | $7.08 | $19.95 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $85.11 Typical High $169.82 | Professional | 54 · Surgery only | $26.92 | $85.11 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $16.98 Typical High $33.88 | Professional | 55 · Aftercare only | $5.37 | $16.98 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $11.48 Typical High $22.91 | Professional | 56 · Pre-op care only | $3.55 | $11.48 | $22.91 |
Where Tennessee sits
The same service costs 4.6 times more in Wisconsin 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· 15th of 51
$151
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.