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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $562.34 Typical High $812.83 | Professional | None | $323.59 | $562.34 | $812.83 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,122.02 Median $3,090.30 Typical High $8,317.64 | Facility | None | $1,122.02 | $3,090.30 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $436.52 Median $831.76 Typical High $1,548.82 | Professional | None | $436.52 | $831.76 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,090.30 Typical High $6,606.93 | Facility | None | $524.81 | $3,090.30 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $562.34 Typical High $1,071.52 | Professional | None | $331.13 | $562.34 | $1,071.52 |
Lucent Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $5,495.41 | Professional | None | $4,466.84 | $4,466.84 | $5,495.41 |
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 $346.74 Median $616.60 Typical High $1,230.27 | Professional | None | $346.74 | $616.60 | $1,230.27 |
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 $158.49 Median $281.84 Typical High $407.38 | Professional | 52 · Reduced service | $158.49 | $281.84 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $112.20 Typical High $162.18 | Professional | 53 · Discontinued | $64.57 | $112.20 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $426.58 Typical High $616.60 | Professional | 54 · Surgery only | $239.88 | $426.58 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $85.11 Typical High $123.03 | Professional | 55 · Aftercare only | $47.86 | $85.11 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $56.23 Typical High $81.28 | Professional | 56 · Pre-op care only | $32.36 | $56.23 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $398.11 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $223.87 | $398.11 | $575.44 |
Where Tennessee sits
The same service costs 4.9 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· 12th of 51
$832
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.