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 $512.86 Median $676.08 Typical High $912.01 | Professional | None | $512.86 | $676.08 | $912.01 |
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 $1,230.27 | Professional | None | $645.65 | $831.76 | $1,230.27 |
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 $537.03 Median $676.08 Typical High $1,174.90 | Professional | None | $537.03 | $676.08 | $1,174.90 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,760.83 | Professional | None | $5,754.40 | $5,754.40 | $6,760.83 |
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 $1,348.96 | Professional | None | $630.96 | $794.33 | $1,348.96 |
7 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 $316.23 Typical High $416.87 | Professional | 52 · Reduced service | $257.04 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $128.82 Typical High $169.82 | Professional | 53 · Discontinued | $102.33 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $478.63 Typical High $630.96 | Professional | 54 · Surgery only | $380.19 | $478.63 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $95.50 Typical High $125.89 | Professional | 55 · Aftercare only | $75.86 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $64.57 Typical High $83.18 | Professional | 56 · Pre-op care only | $51.29 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $446.68 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $354.81 | $446.68 | $588.84 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 51 · Multiple procedures | $239.88 | $239.88 | $239.88 |
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· 17th of 51
$955
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.