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 $602.56 Median $2,290.87 Typical High $7,585.78 | Facility | None | $602.56 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $186.21 | Professional | None | $69.18 | $125.89 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $91.20 Median $151.36 Typical High $245.47 | Professional | None | $91.20 | $151.36 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $263.03 | Professional | None | $97.72 | $154.88 | $263.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,202.26 | $1,412.54 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $81.28 Median $147.91 Typical High $251.19 | Professional | None | $81.28 | $147.91 | $251.19 |
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 $34.67 Median $56.23 Typical High $66.07 | Professional | 52 · Reduced service | $34.67 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $22.39 Typical High $26.92 | Professional | 53 · Discontinued | $13.80 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $85.11 Typical High $100.00 | Professional | 54 · Surgery only | $51.29 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $16.98 Typical High $19.95 | Professional | 55 · Aftercare only | $10.23 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $11.22 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.92 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $79.43 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $47.86 | $79.43 | $93.33 |
Where Tennessee sits
The same service costs 4.5 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
$182
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.