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 $2,630.27 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,630.27 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $380.19 Typical High $524.81 | Professional | None | $158.49 | $380.19 | $524.81 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $186.21 Median $389.05 Typical High $776.25 | Professional | None | $186.21 | $389.05 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $537.03 Typical High $2,187.76 | Facility | None | $354.81 | $537.03 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $346.74 Typical High $630.96 | Professional | None | $151.36 | $346.74 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,162.28 | Professional | None | $2,951.21 | $2,951.21 | $3,162.28 |
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 $162.18 Median $363.08 Typical High $794.33 | Professional | None | $162.18 | $363.08 | $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 $79.43 Median $162.18 Typical High $263.03 | Professional | 52 · Reduced service | $79.43 | $162.18 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $64.57 Typical High $107.15 | Professional | 53 · Discontinued | $31.62 | $64.57 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $239.88 Typical High $398.11 | Professional | 54 · Surgery only | $120.23 | $239.88 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $47.86 Typical High $79.43 | Professional | 55 · Aftercare only | $23.99 | $47.86 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $32.36 Typical High $52.48 | Professional | 56 · Pre-op care only | $15.85 | $32.36 | $52.48 |
Where Tennessee sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 10th of 51
$490
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.