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 $117.49 Median $1,778.28 Typical High $6,606.93 | Facility | None | $117.49 | $1,778.28 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $218.78 | Professional | None | $81.28 | $123.03 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $194.98 | Professional | None | $112.20 | $125.89 | $194.98 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $229.09 | Professional | None | $100.00 | $147.91 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $134.90 Typical High $251.19 | Facility | None | $50.12 | $134.90 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $239.88 | Professional | None | $112.20 | $158.49 | $239.88 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,096.48 | $1,348.96 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $239.88 | Professional | None | $97.72 | $141.25 | $239.88 |
6 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 $40.74 Median $58.88 Typical High $81.28 | Professional | 52 · Reduced service | $40.74 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $23.44 Typical High $32.36 | Professional | 53 · Discontinued | $16.22 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $89.13 Typical High $120.23 | Professional | 54 · Surgery only | $60.26 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $17.78 Typical High $23.99 | Professional | 55 · Aftercare only | $12.02 | $17.78 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $11.75 Typical High $16.22 | Professional | 56 · Pre-op care only | $8.13 | $11.75 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $83.18 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $56.23 | $83.18 | $112.20 |
Where Tennessee sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 18th of 51
$174
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.