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 $602.56 Median $2,290.87 Typical High $7,585.78 | Facility | None | $602.56 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $316.23 Typical High $501.19 | Professional | None | $128.82 | $316.23 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $630.96 | Professional | None | $173.78 | $269.15 | $630.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $162.18 Median $354.81 Typical High $870.96 | Professional | None | $162.18 | $354.81 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $912.01 Typical High $1,659.59 | Facility | None | $389.05 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $323.59 Typical High $549.54 | Professional | None | $134.90 | $323.59 | $549.54 |
Lucent Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,235.94 | Professional | None | $2,884.03 | $2,884.03 | $3,235.94 |
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 $134.90 Median $309.03 Typical High $630.96 | Professional | None | $134.90 | $309.03 | $630.96 |
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 $64.57 Median $147.91 Typical High $239.88 | Professional | 52 · Reduced service | $64.57 | $147.91 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $58.88 Typical High $95.50 | Professional | 53 · Discontinued | $25.70 | $58.88 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $223.87 Typical High $354.81 | Professional | 54 · Surgery only | $95.50 | $223.87 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $44.67 Typical High $70.79 | Professional | 55 · Aftercare only | $19.05 | $44.67 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $29.51 Typical High $47.86 | Professional | 56 · Pre-op care only | $12.88 | $29.51 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $208.93 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $89.13 | $208.93 | $331.13 |
Where Tennessee sits
The same service costs 4.0 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· 14th of 51
$417
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.