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 $181.97 Median $275.42 Typical High $489.78 | Professional | None | $181.97 | $275.42 | $489.78 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $512.86 | Professional | None | $229.09 | $338.84 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $933.25 Typical High $2,187.76 | Facility | None | $524.81 | $933.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $478.63 | Professional | None | $194.98 | $275.42 | $478.63 |
Lucent Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,454.71 | $2,454.71 | $2,951.21 |
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 $223.87 Median $316.23 Typical High $537.03 | Professional | None | $223.87 | $316.23 | $537.03 |
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 $91.20 Median $131.83 Typical High $177.83 | Professional | 52 · Reduced service | $91.20 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $52.48 Typical High $72.44 | Professional | 53 · Discontinued | $37.15 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $199.53 Typical High $269.15 | Professional | 54 · Surgery only | $138.04 | $199.53 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $39.81 Typical High $53.70 | Professional | 55 · Aftercare only | $27.54 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $26.30 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.20 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $186.21 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $128.82 | $186.21 | $251.19 |
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· 12th of 51
$457
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.