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 $812.83 Median $2,398.83 Typical High $7,585.78 | Facility | None | $812.83 | $2,398.83 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $467.74 | Professional | None | $218.78 | $302.00 | $467.74 |
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 $275.42 Median $398.11 Typical High $602.56 | Professional | None | $275.42 | $398.11 | $602.56 |
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 $234.42 Median $323.59 Typical High $549.54 | Professional | None | $234.42 | $323.59 | $549.54 |
Lucent Health Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,388.44 | Professional | None | $2,818.38 | $2,818.38 | $3,388.44 |
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 $269.15 Median $380.19 Typical High $645.65 | Professional | None | $269.15 | $380.19 | $645.65 |
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 $109.65 Median $151.36 Typical High $208.93 | Professional | 52 · Reduced service | $109.65 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $60.26 Typical High $83.18 | Professional | 53 · Discontinued | $43.65 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $229.09 Typical High $309.03 | Professional | 54 · Surgery only | $165.96 | $229.09 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $45.71 Typical High $61.66 | Professional | 55 · Aftercare only | $33.11 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $30.20 Typical High $41.69 | Professional | 56 · Pre-op care only | $21.88 | $30.20 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $213.80 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $154.88 | $213.80 | $288.40 |
Where Tennessee sits
The same service costs 3.9 times more in Alaska than in Utah. 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
$525
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.