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 $933.25 Median $2,818.38 Typical High $7,585.78 | Facility | None | $933.25 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $549.54 | Professional | None | $208.93 | $338.84 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $524.81 | Professional | None | $331.13 | $363.08 | $524.81 |
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 $269.15 Median $416.87 Typical High $645.65 | Professional | None | $269.15 | $416.87 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $501.19 Typical High $2,691.53 | Facility | None | $251.19 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $676.08 | Professional | None | $275.42 | $436.52 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,630.78 | Professional | None | $3,019.95 | $3,019.95 | $3,630.78 |
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 $251.19 Median $407.38 Typical High $676.08 | Professional | None | $251.19 | $407.38 | $676.08 |
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 $100.00 Median $151.36 Typical High $229.09 | Professional | 52 · Reduced service | $100.00 | $151.36 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $61.66 Typical High $91.20 | Professional | 53 · Discontinued | $40.74 | $61.66 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $229.09 Typical High $346.74 | Professional | 54 · Surgery only | $151.36 | $229.09 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $45.71 Typical High $69.18 | Professional | 55 · Aftercare only | $30.20 | $45.71 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $30.20 Typical High $45.71 | Professional | 56 · Pre-op care only | $19.95 | $30.20 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $213.80 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $141.25 | $213.80 | $323.59 |
Where Tennessee sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$457
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.