How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $645.65 | Professional | None | $467.74 | $489.78 | $645.65 |
BCBS Tennessee Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $891.25 | Professional | None | $407.38 | $457.09 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Facility | None | $1,096.48 | $1,096.48 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $758.58 | Professional | None | $426.58 | $467.74 | $758.58 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $4,365.16 Typical High $4,365.16 | Professional | None | $3,630.78 | $4,365.16 | $4,365.16 |
United Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $870.96 | Professional | None | $389.05 | $457.09 | $870.96 |
4 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 $234.42 Median $245.47 Typical High $323.59 | Professional | 52 · Reduced service | $234.42 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $131.83 | Professional | 53 · Discontinued | $93.33 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $97.72 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $64.57 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $64.57 |
Where Tennessee sits
The same service costs 3.2 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· 31st of 51
$513
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.