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 $1,380.38 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,380.38 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $645.65 | Professional | None | $288.40 | $457.09 | $645.65 |
BCBS Tennessee Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $2,818.38 | Facility | None | $537.03 | $1,258.93 | $2,818.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $346.74 Median $616.60 Typical High $1,202.26 | Professional | None | $346.74 | $616.60 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $851.14 Typical High $2,691.53 | Facility | None | $602.56 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $758.58 | Professional | None | $302.00 | $467.74 | $758.58 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,786.30 | Professional | None | $3,630.78 | $3,630.78 | $4,786.30 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $288.40 Median $478.63 Typical High $870.96 | Professional | None | $288.40 | $478.63 | $870.96 |
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 $144.54 Median $223.87 Typical High $323.59 | Professional | 52 · Reduced service | $144.54 | $223.87 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $91.20 Typical High $128.82 | Professional | 53 · Discontinued | $57.54 | $91.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $338.84 Typical High $489.78 | Professional | 54 · Surgery only | $213.80 | $338.84 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $67.61 Typical High $97.72 | Professional | 55 · Aftercare only | $42.66 | $67.61 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $45.71 Typical High $64.57 | Professional | 56 · Pre-op care only | $28.84 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $316.23 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $199.53 | $316.23 | $457.09 |
Where Tennessee sits
The same service costs 5.1 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
$603
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.