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 $77.62 Median $125.89 Typical High $281.84 | Professional | None | $77.62 | $125.89 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $199.53 | Professional | None | $120.23 | $131.83 | $199.53 |
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 $109.65 Median $169.82 Typical High $263.03 | Professional | None | $109.65 | $169.82 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $229.09 Typical High $1,659.59 | Facility | None | $114.82 | $229.09 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $263.03 | Professional | None | $112.20 | $173.78 | $263.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,348.96 | Professional | None | $1,174.90 | $1,174.90 | $1,348.96 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,737.80 | Facility | None | $107.15 | $436.52 | $1,737.80 |
United Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $302.00 | Professional | None | $97.72 | $165.96 | $302.00 |
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 $38.02 Median $54.95 Typical High $64.57 | Professional | 52 · Reduced service | $38.02 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $21.88 Typical High $25.70 | Professional | 53 · Discontinued | $15.14 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $81.28 Typical High $95.50 | Professional | 54 · Surgery only | $57.54 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $16.60 Typical High $19.05 | Professional | 55 · Aftercare only | $11.48 | $16.60 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.96 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.59 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $75.86 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $53.70 | $75.86 | $89.13 |
Where Tennessee sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 19th of 51
$200
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.