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 $1,479.11 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,479.11 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $758.58 | Professional | None | $398.11 | $446.68 | $758.58 |
BCBS Tennessee Setting Facility Modifier None Typical Low $398.11 Median $741.31 Typical High $1,862.09 | Facility | None | $398.11 | $741.31 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $912.01 | Professional | None | $489.78 | $537.03 | $912.01 |
Lucent Health Setting Professional Modifier None Typical Low $3,890.45 Median $4,365.16 Typical High $4,365.16 | Professional | None | $3,890.45 | $4,365.16 | $4,365.16 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
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 $199.53 Median $223.87 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $89.13 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $346.74 | Professional | 54 · Surgery only | $302.00 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $67.61 Typical High $69.18 | Professional | 55 · Aftercare only | $60.26 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $44.67 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $44.67 | $45.71 |
Where Tennessee sits
The same service costs 134.9 times more in Oklahoma than in Hawaii. 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· 21st of 51
$646
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.