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 $123.03 Median $162.18 Typical High $190.55 | Professional | None | $123.03 | $162.18 | $190.55 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,258.93 Typical High $2,818.38 | Facility | None | $575.44 | $1,258.93 | $2,818.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $331.13 | Professional | None | $151.36 | $199.53 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $630.96 Typical High $1,659.59 | Facility | None | $389.05 | $630.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $302.00 | Professional | None | $134.90 | $158.49 | $302.00 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,905.46 | $2,041.74 | $2,041.74 |
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 $134.90 Median $194.98 Typical High $302.00 | Professional | None | $134.90 | $194.98 | $302.00 |
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 $61.66 Median $81.28 Typical High $95.50 | Professional | 52 · Reduced service | $61.66 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $24.55 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $120.23 Typical High $141.25 | Professional | 54 · Surgery only | $91.20 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $23.99 Typical High $28.18 | Professional | 55 · Aftercare only | $18.20 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.22 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.30 | $16.22 | $19.05 |
Where Tennessee sits
The same service costs 4.3 times more in Alaska 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
$513
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.