How much rates vary
Facilitymedian $2,692 · 10th to 90th $977 to $6,457Professionalmedian $1,023 · 10th to 90th $631 to $5,623
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 $2,818.38 Typical High $12,302.69 | Facility | None | $891.25 | $2,818.38 | $12,302.69 |
Aetna Setting Professional Modifier None (both parts) Typical Low $630.96 Median $707.95 Typical High $2,818.38 | Professional | None (both parts) | $630.96 | $707.95 | $2,818.38 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $204.17 Median $223.87 Typical High $288.40 | Professional | 26 · Professional part | $204.17 | $223.87 | $288.40 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $436.52 Median $478.63 Typical High $676.08 | Professional | TC · Technical part | $436.52 | $478.63 | $676.08 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 26 · Professional part | $426.58 | $426.58 | $426.58 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,202.26 Median $2,290.87 Typical High $5,248.07 | Facility | None | $1,202.26 | $2,290.87 | $5,248.07 |
BCBS Tennessee Setting Professional Modifier None (both parts) Typical Low $758.58 Median $977.24 Typical High $1,513.56 | Professional | None (both parts) | $758.58 | $977.24 | $1,513.56 |
BCBS Tennessee Setting Professional Modifier 26 · Professional part Typical Low $245.47 Median $316.23 Typical High $489.78 | Professional | 26 · Professional part | $245.47 | $316.23 | $489.78 |
BCBS Tennessee Setting Professional Modifier TC · Technical part Typical Low $512.86 Median $645.65 Typical High $1,023.29 | Professional | TC · Technical part | $512.86 | $645.65 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $3,311.31 | Facility | None | $512.86 | $512.86 | $3,311.31 |
Cigna Setting Professional Modifier None (both parts) Typical Low $575.44 Median $891.25 Typical High $1,412.54 | Professional | None (both parts) | $575.44 | $891.25 | $1,412.54 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $204.17 Median $316.23 Typical High $457.09 | Professional | 26 · Professional part | $204.17 | $316.23 | $457.09 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $371.54 Median $602.56 Typical High $954.99 | Professional | TC · Technical part | $371.54 | $602.56 | $954.99 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $5,248.07 Median $5,248.07 Typical High $5,623.41 | Professional | None (both parts) | $5,248.07 | $5,248.07 | $5,623.41 |
Lucent Health Setting Professional Modifier 26 · Professional part Typical Low $1,698.24 Median $1,698.24 Typical High $1,862.09 | Professional | 26 · Professional part | $1,698.24 | $1,698.24 | $1,862.09 |
Lucent Health Setting Professional Modifier TC · Technical part Typical Low $2,884.03 Median $2,884.03 Typical High $4,073.80 | Professional | TC · Technical part | $2,884.03 | $2,884.03 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,202.26 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None (both parts) Typical Low $398.11 Median $891.25 Typical High $1,445.44 | Professional | None (both parts) | $398.11 | $891.25 | $1,445.44 |
United Setting Professional Modifier 26 · Professional part Typical Low $213.80 Median $323.59 Typical High $501.19 | Professional | 26 · Professional part | $213.80 | $323.59 | $501.19 |
United Setting Professional Modifier TC · Technical part Typical Low $190.55 Median $616.60 Typical High $977.24 | Professional | TC · Technical part | $190.55 | $616.60 | $977.24 |
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 $316.23 Median $331.13 Typical High $416.87 | Professional | 52 · Reduced service | $316.23 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $165.96 | Professional | 53 · Discontinued | $125.89 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $630.96 | Professional | 54 · Surgery only | $478.63 | $489.78 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $97.72 Typical High $125.89 | Professional | 55 · Aftercare only | $95.50 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $83.18 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $83.18 |
Where Tennessee sits
The same service costs 4.4 times more in Wisconsin than in Texas. 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· 8th of 51
$1,660
WI $2,630TX $603
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.