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 $74.13 Median $114.82 Typical High $177.83 | Professional | None | $74.13 | $114.82 | $177.83 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $223.87 | Professional | None | $100.00 | $144.54 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $117.49 Typical High $218.78 | Facility | None | $50.12 | $117.49 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $208.93 | Professional | None | $79.43 | $123.03 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,096.48 | $1,258.93 |
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 $91.20 Median $141.25 Typical High $239.88 | Professional | None | $91.20 | $141.25 | $239.88 |
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 $37.15 Median $57.54 Typical High $79.43 | Professional | 52 · Reduced service | $37.15 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $22.91 Typical High $31.62 | Professional | 53 · Discontinued | $14.79 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $85.11 Typical High $117.49 | Professional | 54 · Surgery only | $54.95 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $16.98 Typical High $23.44 | Professional | 55 · Aftercare only | $10.96 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $11.48 Typical High $15.85 | Professional | 56 · Pre-op care only | $7.41 | $11.48 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $79.43 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $51.29 | $79.43 | $109.65 |
Where Tennessee sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 16th of 51
$166
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.