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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $295.12 | Professional | None | $114.82 | $181.97 | $295.12 |
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 $151.36 Median $223.87 Typical High $346.74 | Professional | None | $151.36 | $223.87 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $338.84 Typical High $1,659.59 | Facility | None | $173.78 | $338.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $323.59 | Professional | None | $123.03 | $190.55 | $323.59 |
Lucent Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,659.59 | $1,949.84 |
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 $141.25 Median $213.80 Typical High $363.08 | Professional | None | $141.25 | $213.80 | $363.08 |
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 $89.13 Typical High $123.03 | Professional | 52 · Reduced service | $57.54 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $35.48 Typical High $48.98 | Professional | 53 · Discontinued | $22.91 | $35.48 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $131.83 Typical High $181.97 | Professional | 54 · Surgery only | $87.10 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $26.92 Typical High $37.15 | Professional | 55 · Aftercare only | $17.38 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $17.78 Typical High $24.55 | Professional | 56 · Pre-op care only | $11.48 | $17.78 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $123.03 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $81.28 | $123.03 | $169.82 |
Where Tennessee sits
The same service costs 3.4 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
$275
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.