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 $181.97 Median $1,778.28 Typical High $6,606.93 | Facility | None | $181.97 | $1,778.28 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $316.23 | Professional | None | $128.82 | $181.97 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $144.54 | Professional | None | $81.28 | $107.15 | $144.54 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $331.13 | Professional | None | $158.49 | $223.87 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $912.01 Typical High $1,659.59 | Facility | None | $389.05 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $316.23 | Professional | None | $134.90 | $186.21 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,621.81 | $1,621.81 | $1,995.26 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $354.81 | Professional | None | $151.36 | $208.93 | $354.81 |
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 $63.10 Median $87.10 Typical High $120.23 | Professional | 52 · Reduced service | $63.10 | $87.10 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $34.67 Typical High $47.86 | Professional | 53 · Discontinued | $25.12 | $34.67 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $131.83 Typical High $177.83 | Professional | 54 · Surgery only | $93.33 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $26.30 Typical High $35.48 | Professional | 55 · Aftercare only | $19.05 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $17.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $12.59 | $17.38 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $123.03 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $87.10 | $123.03 | $165.96 |
Where Tennessee sits
The same service costs 4.6 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· 16th of 51
$295
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.