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 $794.33 Median $2,691.53 Typical High $6,606.93 | Facility | None | $794.33 | $2,691.53 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,445.44 | Professional | None | $630.96 | $851.14 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,819.70 | Professional | None | $933.25 | $1,122.02 | $1,819.70 |
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 $794.33 Median $1,047.13 Typical High $1,548.82 | Professional | None | $794.33 | $1,047.13 | $1,548.82 |
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 $676.08 Median $870.96 Typical High $1,479.11 | Professional | None | $676.08 | $870.96 | $1,479.11 |
Lucent Health Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $8,511.38 | Professional | None | $7,244.36 | $7,244.36 | $8,511.38 |
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 $776.25 Median $977.24 Typical High $1,698.24 | Professional | None | $776.25 | $977.24 | $1,698.24 |
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 $316.23 Median $398.11 Typical High $524.81 | Professional | 52 · Reduced service | $316.23 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $158.49 Typical High $208.93 | Professional | 53 · Discontinued | $125.89 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $602.56 Typical High $794.33 | Professional | 54 · Surgery only | $478.63 | $602.56 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $120.23 Typical High $158.49 | Professional | 55 · Aftercare only | $95.50 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $79.43 Typical High $104.71 | Professional | 56 · Pre-op care only | $63.10 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $562.34 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $446.68 | $562.34 | $741.31 |
Where Tennessee sits
The same service costs 4.5 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· 22nd of 51
$1,148
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.