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 $131.83 Median $190.55 Typical High $288.40 | Professional | None | $131.83 | $190.55 | $288.40 |
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 $169.82 Median $251.19 Typical High $371.54 | Professional | None | $169.82 | $251.19 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $323.59 Typical High $1,659.59 | Facility | None | $165.96 | $323.59 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $346.74 | Professional | None | $138.04 | $204.17 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,041.74 | Professional | None | $1,778.28 | $1,778.28 | $2,041.74 |
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 $165.96 Median $234.42 Typical High $398.11 | Professional | None | $165.96 | $234.42 | $398.11 |
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 $66.07 Median $95.50 Typical High $128.82 | Professional | 52 · Reduced service | $66.07 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $38.02 Typical High $52.48 | Professional | 53 · Discontinued | $26.30 | $38.02 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $194.98 | Professional | 54 · Surgery only | $97.72 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $38.90 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.05 Typical High $26.30 | Professional | 56 · Pre-op care only | $13.18 | $19.05 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $134.90 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $91.20 | $134.90 | $181.97 |
Where Tennessee sits
The same service costs 3.5 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· 16th of 51
$288
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.