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 $61.66 Median $85.11 Typical High $117.49 | Professional | None | $61.66 | $85.11 | $117.49 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $194.98 | Professional | None | $72.44 | $100.00 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $104.71 Typical High $1,659.59 | Facility | None | $53.70 | $104.71 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $162.18 | Professional | None | $58.88 | $89.13 | $162.18 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,737.80 | Facility | None | $107.15 | $436.52 | $1,737.80 |
United Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $177.83 | Professional | None | $63.10 | $102.33 | $177.83 |
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 $30.90 Median $42.66 Typical High $58.88 | Professional | 52 · Reduced service | $30.90 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $16.98 Typical High $23.44 | Professional | 53 · Discontinued | $12.30 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $63.10 Typical High $87.10 | Professional | 54 · Surgery only | $45.71 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.59 Typical High $17.78 | Professional | 55 · Aftercare only | $9.12 | $12.59 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.51 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.17 | $8.51 | $11.75 |
Where Tennessee sits
The same service costs 3.5 times more in Wisconsin than in Florida. 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· 17th of 51
$120
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.