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 $154.88 Median $323.59 Typical High $478.63 | Professional | None | $154.88 | $323.59 | $478.63 |
BCBS Tennessee Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $1,584.89 | Facility | None | $104.71 | $147.91 | $1,584.89 |
BCBS Tennessee Setting Professional Modifier None Typical Low $199.53 Median $371.54 Typical High $630.96 | Professional | None | $199.53 | $371.54 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $316.23 Typical High $575.44 | Professional | None | $144.54 | $316.23 | $575.44 |
Lucent Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,162.28 | Professional | None | $2,454.71 | $2,454.71 | $3,162.28 |
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 $165.96 Median $331.13 Typical High $676.08 | Professional | None | $165.96 | $331.13 | $676.08 |
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 $77.62 Median $147.91 Typical High $229.09 | Professional | 52 · Reduced service | $77.62 | $147.91 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $58.88 Typical High $93.33 | Professional | 53 · Discontinued | $30.90 | $58.88 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $218.78 Typical High $346.74 | Professional | 54 · Surgery only | $114.82 | $218.78 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $44.67 Typical High $69.18 | Professional | 55 · Aftercare only | $23.44 | $44.67 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $29.51 Typical High $45.71 | Professional | 56 · Pre-op care only | $15.49 | $29.51 | $45.71 |
Where Tennessee sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 22nd of 51
$363
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.