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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $426.58 | Professional | None | $169.82 | $251.19 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $389.05 | Professional | None | $173.78 | $263.03 | $389.05 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $478.63 | Professional | None | $208.93 | $309.03 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $562.34 Typical High $2,187.76 | Facility | None | $436.52 | $562.34 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $436.52 | Professional | None | $177.83 | $257.04 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,691.53 | Professional | None | $2,238.72 | $2,238.72 | $2,691.53 |
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 $199.53 Median $295.12 Typical High $501.19 | Professional | None | $199.53 | $295.12 | $501.19 |
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 $83.18 Median $123.03 Typical High $165.96 | Professional | 52 · Reduced service | $83.18 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $48.98 Typical High $66.07 | Professional | 53 · Discontinued | $33.11 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $181.97 Typical High $251.19 | Professional | 54 · Surgery only | $123.03 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $36.31 Typical High $50.12 | Professional | 55 · Aftercare only | $24.55 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $24.55 Typical High $33.11 | Professional | 56 · Pre-op care only | $16.60 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $169.82 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $114.82 | $169.82 | $234.42 |
Where Tennessee sits
The same service costs 3.6 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· 14th of 51
$389
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.