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 $77.62 Median $102.33 Typical High $147.91 | Professional | None | $77.62 | $102.33 | $147.91 |
BCBS Tennessee Setting Facility Modifier None Typical Low $100.00 Median $138.04 Typical High $501.19 | Facility | None | $100.00 | $138.04 | $501.19 |
BCBS Tennessee Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $194.98 | Professional | None | $91.20 | $120.23 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $199.53 | Professional | None | $74.13 | $107.15 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $954.99 | Professional | None | $912.01 | $912.01 | $954.99 |
United Setting Facility Modifier None Typical Low $302.00 Median $724.44 Typical High $2,570.40 | Facility | None | $302.00 | $724.44 | $2,570.40 |
United Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $213.80 | Professional | None | $75.86 | $112.20 | $213.80 |
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 $38.02 Median $51.29 Typical High $74.13 | Professional | 52 · Reduced service | $38.02 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $20.42 Typical High $29.51 | Professional | 53 · Discontinued | $15.49 | $20.42 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $77.62 Typical High $112.20 | Professional | 54 · Surgery only | $57.54 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $15.49 Typical High $22.39 | Professional | 55 · Aftercare only | $11.48 | $15.49 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.23 Typical High $14.79 | Professional | 56 · Pre-op care only | $7.76 | $10.23 | $14.79 |
Where Tennessee sits
The same service costs 3.8 times more in Alaska 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· 23rd of 51
$126
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.