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 $158.49 Median $1,819.70 Typical High $6,606.93 | Facility | None | $158.49 | $1,819.70 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $275.42 | Professional | None | $117.49 | $162.18 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $275.42 | Professional | None | $77.62 | $100.00 | $275.42 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $288.40 | Professional | None | $144.54 | $194.98 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $295.12 Typical High $1,659.59 | Facility | None | $147.91 | $295.12 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $281.84 | Professional | None | $123.03 | $162.18 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,445.44 | $1,445.44 | $1,737.80 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $316.23 | Professional | None | $138.04 | $181.97 | $316.23 |
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 $57.54 Median $77.62 Typical High $104.71 | Professional | 52 · Reduced service | $57.54 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.90 Typical High $41.69 | Professional | 53 · Discontinued | $22.91 | $30.90 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $114.82 Typical High $158.49 | Professional | 54 · Surgery only | $85.11 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.91 Typical High $31.62 | Professional | 55 · Aftercare only | $16.98 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.49 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.48 | $15.49 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $107.15 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $79.43 | $107.15 | $147.91 |
Where Tennessee sits
The same service costs 4.0 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· 17th of 51
$234
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.