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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $229.09 | Professional | None | $95.50 | $151.36 | $229.09 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $288.40 | Professional | None | $128.82 | $186.21 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $269.15 | Professional | None | $102.33 | $158.49 | $269.15 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,412.54 | $1,412.54 | $1,621.81 |
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 $120.23 Median $181.97 Typical High $302.00 | Professional | None | $120.23 | $181.97 | $302.00 |
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 $47.86 Median $72.44 Typical High $102.33 | Professional | 52 · Reduced service | $47.86 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $28.84 Typical High $40.74 | Professional | 53 · Discontinued | $19.05 | $28.84 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $107.15 Typical High $154.88 | Professional | 54 · Surgery only | $70.79 | $107.15 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $21.38 Typical High $30.90 | Professional | 55 · Aftercare only | $14.13 | $21.38 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $14.45 Typical High $20.42 | Professional | 56 · Pre-op care only | $9.55 | $14.45 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $100.00 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $66.07 | $100.00 | $144.54 |
Where Tennessee sits
The same service costs 3.3 times more in Alaska than in Maryland. 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
$214
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.