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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $575.44 | Professional | None | $316.23 | $426.58 | $575.44 |
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 $398.11 Median $575.44 Typical High $831.76 | Professional | None | $398.11 | $575.44 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $407.38 Typical High $776.25 | Facility | None | $50.12 | $407.38 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $794.33 | Professional | None | $338.84 | $446.68 | $794.33 |
Lucent Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $912.01 | Professional | None | $389.05 | $524.81 | $912.01 |
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 $158.49 Median $208.93 Typical High $281.84 | Professional | 52 · Reduced service | $158.49 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $83.18 Typical High $112.20 | Professional | 53 · Discontinued | $63.10 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $316.23 Typical High $426.58 | Professional | 54 · Surgery only | $234.42 | $316.23 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $63.10 Typical High $85.11 | Professional | 55 · Aftercare only | $46.77 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $41.69 Typical High $56.23 | Professional | 56 · Pre-op care only | $31.62 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $295.12 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $218.78 | $295.12 | $398.11 |
Where Tennessee sits
The same service costs 5.1 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· 25th of 51
$537
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.