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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $346.74 | Professional | None | $169.82 | $186.21 | $346.74 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $407.38 | Professional | None | $204.17 | $263.03 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $1,000.00 | Facility | None | $512.86 | $512.86 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $380.19 | Professional | None | $165.96 | $251.19 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,148.15 | $1,412.54 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $416.87 | Professional | None | $173.78 | $245.47 | $416.87 |
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 $85.11 Median $87.10 Typical High $112.20 | Professional | 52 · Reduced service | $85.11 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $34.67 Typical High $44.67 | Professional | 53 · Discontinued | $33.88 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $131.83 Typical High $169.82 | Professional | 54 · Surgery only | $128.82 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.30 Typical High $33.88 | Professional | 55 · Aftercare only | $25.70 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $16.98 | $17.38 | $22.39 |
Where Tennessee sits
The same service costs 3.8 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· 2nd of 51
$724
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.