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 $72.44 Median $177.83 Typical High $309.03 | Professional | None | $72.44 | $177.83 | $309.03 |
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 $77.62 Median $181.97 Typical High $288.40 | Professional | None | $77.62 | $181.97 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $645.65 Typical High $1,659.59 | Facility | None | $389.05 | $645.65 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $162.18 Typical High $281.84 | Professional | None | $87.10 | $162.18 | $281.84 |
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 $75.86 Median $165.96 Typical High $302.00 | Professional | None | $75.86 | $165.96 | $302.00 |
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 $36.31 Median $81.28 Typical High $154.88 | Professional | 52 · Reduced service | $36.31 | $81.28 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $32.36 Typical High $61.66 | Professional | 53 · Discontinued | $14.45 | $32.36 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $120.23 Typical High $234.42 | Professional | 54 · Surgery only | $53.70 | $120.23 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $23.99 Typical High $46.77 | Professional | 55 · Aftercare only | $10.72 | $23.99 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $16.22 Typical High $30.90 | Professional | 56 · Pre-op care only | $7.24 | $16.22 | $30.90 |
Where Tennessee sits
The same service costs 4.1 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· 21st of 51
$204
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.