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 $112.20 Median $239.88 Typical High $354.81 | Professional | None | $112.20 | $239.88 | $354.81 |
BCBS Tennessee Setting Facility Modifier None Typical Low $758.58 Median $1,479.11 Typical High $2,290.87 | Facility | None | $758.58 | $1,479.11 | $2,290.87 |
BCBS Tennessee Setting Professional Modifier None Typical Low $147.91 Median $275.42 Typical High $478.63 | Professional | None | $147.91 | $275.42 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $234.42 Typical High $436.52 | Professional | None | $109.65 | $234.42 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,454.71 | Professional | None | $2,137.96 | $2,137.96 | $2,454.71 |
United Setting Facility Modifier None Typical Low $776.25 Median $1,479.11 Typical High $2,884.03 | Facility | None | $776.25 | $1,479.11 | $2,884.03 |
United Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $512.86 | Professional | None | $120.23 | $251.19 | $512.86 |
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 $56.23 Median $109.65 Typical High $165.96 | Professional | 52 · Reduced service | $56.23 | $109.65 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $43.65 Typical High $67.61 | Professional | 53 · Discontinued | $22.91 | $43.65 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $162.18 Typical High $251.19 | Professional | 54 · Surgery only | $85.11 | $162.18 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $33.11 Typical High $50.12 | Professional | 55 · Aftercare only | $16.98 | $33.11 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $21.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $11.22 | $21.88 | $33.88 |
Where Tennessee sits
The same service costs 3.4 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· 19th of 51
$288
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.