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 $158.49 Median $245.47 Typical High $416.87 | Professional | None | $158.49 | $245.47 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $309.03 | Professional | None | $158.49 | $288.40 | $309.03 |
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 $204.17 Median $302.00 Typical High $446.68 | Professional | None | $204.17 | $302.00 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $245.47 Typical High $467.74 | Facility | None | $50.12 | $245.47 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $501.19 | Professional | None | $213.80 | $316.23 | $501.19 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,691.53 | Professional | None | $2,290.87 | $2,290.87 | $2,691.53 |
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 $190.55 Median $288.40 Typical High $478.63 | Professional | None | $190.55 | $288.40 | $478.63 |
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 $77.62 Median $117.49 Typical High $165.96 | Professional | 52 · Reduced service | $77.62 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $46.77 Typical High $67.61 | Professional | 53 · Discontinued | $30.90 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $177.83 Typical High $251.19 | Professional | 54 · Surgery only | $114.82 | $177.83 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $35.48 Typical High $50.12 | Professional | 55 · Aftercare only | $23.44 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $23.44 Typical High $33.11 | Professional | 56 · Pre-op care only | $15.49 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $165.96 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $107.15 | $165.96 | $234.42 |
Where Tennessee sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 18th of 51
$339
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.