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 $67.61 Median $158.49 Typical High $295.12 | Professional | None | $67.61 | $158.49 | $295.12 |
BCBS Tennessee Setting Professional Modifier None Typical Low $63.10 Median $144.54 Typical High $204.17 | Professional | None | $63.10 | $144.54 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $181.97 Typical High $269.15 | Facility | None | $162.18 | $181.97 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $85.11 Typical High $229.09 | Professional | None | $36.31 | $85.11 | $229.09 |
Lucent Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | None | $1,230.27 | $1,230.27 | $1,258.93 |
United Setting Professional Modifier None Typical Low $69.18 Median $147.91 Typical High $257.04 | Professional | None | $69.18 | $147.91 | $257.04 |
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 $33.88 Median $69.18 Typical High $89.13 | Professional | 52 · Reduced service | $33.88 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $27.54 Typical High $35.48 | Professional | 53 · Discontinued | $13.49 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $104.71 Typical High $134.90 | Professional | 54 · Surgery only | $51.29 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $20.89 Typical High $26.92 | Professional | 55 · Aftercare only | $10.23 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $13.80 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.76 | $13.80 | $17.78 |
Where Tennessee sits
The same service costs 3.5 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· 26th of 51
$155
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.