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 $2,630.27 Median $2,884.03 Typical High $7,585.78 | Facility | None | $2,630.27 | $2,884.03 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $3,019.95 Typical High $4,073.80 | Professional | None | $2,884.03 | $3,019.95 | $4,073.80 |
BCBS Tennessee Setting Facility Modifier None Typical Low $2,398.83 Median $6,309.57 Typical High $12,022.64 | Facility | None | $2,398.83 | $6,309.57 | $12,022.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $3,311.31 Median $4,677.35 Typical High $7,762.47 | Professional | None | $3,311.31 | $4,677.35 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $14,791.08 Typical High $30,199.52 | Facility | None | $602.56 | $14,791.08 | $30,199.52 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $3,890.45 Typical High $5,370.32 | Professional | None | $2,951.21 | $3,890.45 | $5,370.32 |
Lucent Health Setting Professional Modifier None Typical Low $28,183.83 Median $28,183.83 Typical High $28,183.83 | Professional | None | $28,183.83 | $28,183.83 | $28,183.83 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $10,000.00 Typical High $15,848.93 | Facility | None | $3,630.78 | $10,000.00 | $15,848.93 |
United Setting Professional Modifier None Typical Low $2,630.27 Median $3,548.13 Typical High $6,760.83 | Professional | None | $2,630.27 | $3,548.13 | $6,760.83 |
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 $1,412.54 Median $1,513.56 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,412.54 | $1,513.56 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $602.56 Typical High $812.83 | Professional | 53 · Discontinued | $575.44 | $602.56 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,290.87 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,137.96 | $2,290.87 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $457.09 Typical High $616.60 | Professional | 55 · Aftercare only | $426.58 | $457.09 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $302.00 Typical High $407.38 | Professional | 56 · Pre-op care only | $288.40 | $302.00 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,137.96 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,137.96 | $2,884.03 |
Where Tennessee sits
The same service costs 20.4 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· 20th of 51
$4,677
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.