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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $162.18 Typical High $245.47 | Professional | None | $83.18 | $162.18 | $245.47 |
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 $89.13 Median $147.91 Typical High $257.04 | Professional | None | $89.13 | $147.91 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $3,090.30 | Facility | None | $524.81 | $1,698.24 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $234.42 | Professional | None | $97.72 | $162.18 | $234.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,258.93 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $87.10 Median $151.36 Typical High $275.42 | Professional | None | $87.10 | $151.36 | $275.42 |
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 $40.74 Median $74.13 Typical High $123.03 | Professional | 52 · Reduced service | $40.74 | $74.13 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $29.51 Typical High $48.98 | Professional | 53 · Discontinued | $16.60 | $29.51 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $112.20 Typical High $186.21 | Professional | 54 · Surgery only | $61.66 | $112.20 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $22.39 Typical High $37.15 | Professional | 55 · Aftercare only | $12.30 | $22.39 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $15.14 Typical High $24.55 | Professional | 56 · Pre-op care only | $8.32 | $15.14 | $24.55 |
Where Tennessee sits
The same service costs 3.6 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· 30th of 51
$170
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.