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 $2,290.87 Median $3,890.45 Typical High $4,168.69 | Facility | None | $2,290.87 | $3,890.45 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,584.89 | $2,290.87 | $2,818.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,548.82 Median $2,630.27 Typical High $9,549.93 | Professional | None | $1,548.82 | $2,630.27 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Lucent Health Setting Professional Modifier None Typical Low $19,054.61 Median $19,054.61 Typical High $28,183.83 | Professional | None | $19,054.61 | $19,054.61 | $28,183.83 |
United Setting Facility Modifier None Typical Low $3,801.89 Median $5,754.40 Typical High $10,000.00 | Facility | None | $3,801.89 | $5,754.40 | $10,000.00 |
United Setting Professional Modifier None Typical Low $213.80 Median $2,818.38 Typical High $5,888.44 | Professional | None | $213.80 | $2,818.38 | $5,888.44 |
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 $776.25 Median $1,148.15 Typical High $1,348.96 | Professional | 52 · Reduced service | $776.25 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $467.74 Typical High $537.03 | Professional | 53 · Discontinued | $316.23 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,737.80 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,174.90 | $1,737.80 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $346.74 Typical High $407.38 | Professional | 55 · Aftercare only | $234.42 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $229.09 Typical High $269.15 | Professional | 56 · Pre-op care only | $158.49 | $229.09 | $269.15 |
Where Tennessee sits
The same service costs 14.1 times more in Alaska than in Missouri. 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· 20th of 51
$3,631
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.