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 $239.88 Median $338.84 Typical High $489.78 | Professional | None | $239.88 | $338.84 | $489.78 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $891.25 | Professional | None | $323.59 | $512.86 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $575.44 Typical High $2,691.53 | Facility | None | $295.12 | $575.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $602.56 | Professional | None | $239.88 | $354.81 | $602.56 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,311.31 | Professional | None | $2,691.53 | $2,691.53 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $691.83 | Professional | None | $245.47 | $371.54 | $691.83 |
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 $120.23 Median $169.82 Typical High $245.47 | Professional | 52 · Reduced service | $120.23 | $169.82 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $67.61 Typical High $97.72 | Professional | 53 · Discontinued | $47.86 | $67.61 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $257.04 Typical High $371.54 | Professional | 54 · Surgery only | $177.83 | $257.04 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $51.29 Typical High $74.13 | Professional | 55 · Aftercare only | $35.48 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $33.88 Typical High $48.98 | Professional | 56 · Pre-op care only | $23.99 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $239.88 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $165.96 | $239.88 | $346.74 |
Where Tennessee sits
The same service costs 5.2 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· 14th of 51
$490
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.