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 $229.09 Median $323.59 Typical High $467.74 | Professional | None | $229.09 | $323.59 | $467.74 |
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 $288.40 Median $457.09 Typical High $851.14 | Professional | None | $288.40 | $457.09 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $346.74 Typical High $630.96 | Facility | None | $52.48 | $346.74 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $575.44 | Professional | None | $239.88 | $346.74 | $575.44 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,691.53 | $3,467.37 | $3,467.37 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $630.96 | Professional | None | $229.09 | $346.74 | $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 $114.82 Median $162.18 Typical High $234.42 | Professional | 52 · Reduced service | $114.82 | $162.18 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $64.57 Typical High $93.33 | Professional | 53 · Discontinued | $45.71 | $64.57 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $245.47 Typical High $346.74 | Professional | 54 · Surgery only | $169.82 | $245.47 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $48.98 Typical High $70.79 | Professional | 55 · Aftercare only | $33.88 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $32.36 Typical High $46.77 | Professional | 56 · Pre-op care only | $22.91 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $229.09 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $158.49 | $229.09 | $323.59 |
Where Tennessee sits
The same service costs 4.5 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· 19th of 51
$427
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.