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 $52.48 Median $2,818.38 Typical High $7,585.78 | Facility | None | $52.48 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $56.23 Typical High $85.11 | Professional | None | $38.90 | $56.23 | $85.11 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $89.13 | Professional | None | $44.67 | $60.26 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $50.12 Typical High $83.18 | Professional | None | $34.67 | $50.12 | $83.18 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,995.26 | $1,995.26 |
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 |
United Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $95.50 | Professional | None | $39.81 | $57.54 | $95.50 |
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 $19.50 Median $28.18 Typical High $42.66 | Professional | 52 · Reduced service | $19.50 | $28.18 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $11.22 Typical High $16.98 | Professional | 53 · Discontinued | $7.76 | $11.22 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $42.66 Typical High $63.10 | Professional | 54 · Surgery only | $29.51 | $42.66 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $8.51 Typical High $12.59 | Professional | 55 · Aftercare only | $5.89 | $8.51 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.62 Typical High $8.51 | Professional | 56 · Pre-op care only | $3.89 | $5.62 | $8.51 |
Where Tennessee sits
The same service costs 3.8 times more in Alaska than in Maryland. 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· 20th of 51
$72.44
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.