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 $95.50 Median $97.72 Typical High $151.36 | Professional | None | $95.50 | $97.72 | $151.36 |
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 |
BCBS Tennessee Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $269.15 | Professional | None | $100.00 | $138.04 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $512.86 Typical High $1,659.59 | Facility | None | $389.05 | $512.86 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $213.80 | Professional | None | $95.50 | $123.03 | $213.80 |
Lucent Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $954.99 | Professional | None | $831.76 | $831.76 | $954.99 |
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 $97.72 Median $141.25 Typical High $229.09 | Professional | None | $97.72 | $141.25 | $229.09 |
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 $47.86 Median $47.86 Typical High $69.18 | Professional | 52 · Reduced service | $47.86 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.50 Typical High $27.54 | Professional | 53 · Discontinued | $19.05 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $72.44 Typical High $104.71 | Professional | 54 · Surgery only | $70.79 | $72.44 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.45 Typical High $20.89 | Professional | 55 · Aftercare only | $14.13 | $14.45 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.77 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.55 | $9.77 | $13.80 |
Where Tennessee sits
The same service costs 4.4 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
$437
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.