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 $616.60 Median $2,691.53 Typical High $6,606.93 | Facility | None | $616.60 | $2,691.53 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,122.02 | Professional | None | $537.03 | $691.83 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $977.24 Typical High $977.24 | Professional | None | $537.03 | $977.24 | $977.24 |
BCBS Tennessee Setting Facility Modifier None Typical Low $870.96 Median $1,621.81 Typical High $3,548.13 | Facility | None | $870.96 | $1,621.81 | $3,548.13 |
BCBS Tennessee Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,174.90 | Professional | None | $645.65 | $831.76 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,412.54 Typical High $2,691.53 | Facility | None | $602.56 | $1,412.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $1,174.90 | Professional | None | $549.54 | $660.69 | $1,174.90 |
Lucent Health Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Professional | None | $7,079.46 | $7,079.46 | $7,079.46 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,318.26 | Professional | None | $630.96 | $794.33 | $1,318.26 |
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 $257.04 Median $309.03 Typical High $407.38 | Professional | 52 · Reduced service | $257.04 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $123.03 Typical High $162.18 | Professional | 53 · Discontinued | $102.33 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $467.74 Typical High $602.56 | Professional | 54 · Surgery only | $389.05 | $467.74 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $120.23 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $61.66 Typical High $81.28 | Professional | 56 · Pre-op care only | $51.29 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $436.52 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $363.08 | $436.52 | $562.34 |
Where Tennessee sits
The same service costs 4.6 times more in Alaska than in Texas. 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· 20th of 51
$912
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.