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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,318.26 | $2,137.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,412.54 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,412.54 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,348.96 | $1,949.84 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,090.30 Typical High $6,606.93 | Facility | None | $588.84 | $3,090.30 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,659.59 | $2,290.87 |
Lucent Health Setting Professional Modifier None Typical Low $15,488.17 Median $15,488.17 Typical High $15,488.17 | Professional | None | $15,488.17 | $15,488.17 | $15,488.17 |
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 $1,122.02 Median $1,412.54 Typical High $2,818.38 | Professional | None | $1,122.02 | $1,412.54 | $2,818.38 |
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 $602.56 Median $630.96 Typical High $891.25 | Professional | 52 · Reduced service | $602.56 | $630.96 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $257.04 Typical High $354.81 | Professional | 53 · Discontinued | $245.47 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $1,318.26 | Professional | 54 · Surgery only | $912.01 | $954.99 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $263.03 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $125.89 Typical High $177.83 | Professional | 56 · Pre-op care only | $123.03 | $125.89 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $1,230.27 |
Where Tennessee sits
The same service costs 17.0 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
$2,042
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.