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 $707.95 Median $2,818.38 Typical High $7,585.78 | Facility | None | $707.95 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $512.86 | Professional | None | $199.53 | $316.23 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $363.08 Typical High $398.11 | Professional | None | $102.33 | $363.08 | $398.11 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $831.76 Typical High $1,995.26 | Facility | None | $407.38 | $831.76 | $1,995.26 |
BCBS Tennessee Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $602.56 | Professional | None | $263.03 | $389.05 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $630.96 Typical High $2,691.53 | Facility | None | $457.09 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $630.96 | Professional | None | $263.03 | $398.11 | $630.96 |
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 $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 $239.88 Median $380.19 Typical High $630.96 | Professional | None | $239.88 | $380.19 | $630.96 |
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 $97.72 Median $147.91 Typical High $213.80 | Professional | 52 · Reduced service | $97.72 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $58.88 Typical High $85.11 | Professional | 53 · Discontinued | $38.90 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $218.78 Typical High $323.59 | Professional | 54 · Surgery only | $144.54 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $43.65 Typical High $64.57 | Professional | 55 · Aftercare only | $28.84 | $43.65 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $29.51 Typical High $42.66 | Professional | 56 · Pre-op care only | $19.50 | $29.51 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $204.17 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $134.90 | $204.17 | $302.00 |
Where Tennessee sits
The same service costs 3.3 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· 19th of 51
$437
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.