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 $165.96 Median $295.12 Typical High $457.09 | Professional | None | $165.96 | $295.12 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $537.03 | Professional | None | $218.78 | $346.74 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $575.44 Typical High $2,187.76 | Facility | None | $457.09 | $575.44 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $602.56 | Professional | None | $229.09 | $354.81 | $602.56 |
Lucent Health Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,754.23 | $2,754.23 | $3,388.44 |
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 $204.17 Median $331.13 Typical High $562.34 | Professional | None | $204.17 | $331.13 | $562.34 |
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 $83.18 Median $128.82 Typical High $204.17 | Professional | 52 · Reduced service | $83.18 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $51.29 Typical High $81.28 | Professional | 53 · Discontinued | $33.11 | $51.29 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $194.98 Typical High $302.00 | Professional | 54 · Surgery only | $123.03 | $194.98 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $38.90 Typical High $60.26 | Professional | 55 · Aftercare only | $24.55 | $38.90 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $25.70 Typical High $40.74 | Professional | 56 · Pre-op care only | $16.60 | $25.70 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $181.97 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $114.82 | $181.97 | $281.84 |
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
$417
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.