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 $2,344.23 Median $5,370.32 Typical High $31,622.78 | Facility | None | $2,344.23 | $5,370.32 | $31,622.78 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $5,370.32 | Professional | None | $912.01 | $912.01 | $5,370.32 |
BCBS Tennessee Setting Facility Modifier None Typical Low $3,801.89 Median $8,317.64 Typical High $14,125.38 | Facility | None | $3,801.89 | $8,317.64 | $14,125.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $9,332.54 Median $17,378.01 Typical High $21,379.62 | Professional | None | $9,332.54 | $17,378.01 | $21,379.62 |
Cigna Setting Facility Modifier None Typical Low $9,772.37 Median $15,135.61 Typical High $28,183.83 | Facility | None | $9,772.37 | $15,135.61 | $28,183.83 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $10,232.93 Typical High $22,387.21 | Facility | None | $3,630.78 | $10,232.93 | $22,387.21 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Where Tennessee sits
The same service costs 5754.4 times more in Oklahoma than in Maine. 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· 29th of 51
$10,000
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.