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 $338.84 Median $389.05 Typical High $691.83 | Professional | None | $338.84 | $389.05 | $691.83 |
BCBS Tennessee Setting Facility Modifier None Typical Low $977.24 Median $2,398.83 Typical High $6,309.57 | Facility | None | $977.24 | $2,398.83 | $6,309.57 |
BCBS Tennessee Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $851.14 | Professional | None | $371.54 | $501.19 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $2,818.38 Typical High $5,888.44 | Facility | None | $389.05 | $2,818.38 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $724.44 | Professional | None | $323.59 | $416.87 | $724.44 |
Lucent Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,630.27 | Professional | None | $2,570.40 | $2,570.40 | $2,630.27 |
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 $331.13 Median $501.19 Typical High $794.33 | Professional | None | $331.13 | $501.19 | $794.33 |
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 $169.82 Median $194.98 Typical High $234.42 | Professional | 52 · Reduced service | $169.82 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $77.62 Typical High $95.50 | Professional | 53 · Discontinued | $69.18 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $288.40 Typical High $354.81 | Professional | 54 · Surgery only | $257.04 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $57.54 Typical High $70.79 | Professional | 55 · Aftercare only | $51.29 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.90 Typical High $46.77 | Professional | 56 · Pre-op care only | $33.88 | $38.90 | $46.77 |
Where Tennessee sits
The same service costs 7.8 times more in Oklahoma than in New York. 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· 4th of 51
$1,202
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.