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 $1,479.11 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,479.11 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,621.81 | Professional | None | $912.01 | $1,047.13 | $1,621.81 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,318.26 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,621.81 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $6,606.93 | Facility | None | $602.56 | $3,090.30 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $1,862.09 | Professional | None | $933.25 | $1,318.26 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Professional | None | $9,120.11 | $9,120.11 | $9,120.11 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $2,137.96 | Professional | None | $870.96 | $1,202.26 | $2,137.96 |
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 $457.09 Median $489.78 Typical High $660.69 | Professional | 52 · Reduced service | $457.09 | $489.78 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $269.15 | Professional | 53 · Discontinued | $181.97 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $1,000.00 | Professional | 54 · Surgery only | $691.83 | $741.31 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $199.53 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $134.90 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $933.25 |
Where Tennessee sits
The same service costs 18.2 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· 15th of 51
$1,698
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.