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 $239.88 Median $1,949.84 Typical High $6,606.93 | Facility | None | $239.88 | $1,949.84 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $338.84 | Professional | None | $138.04 | $239.88 | $338.84 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $630.96 | Professional | None | $177.83 | $323.59 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $912.01 Typical High $1,659.59 | Facility | None | $389.05 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $389.05 | Professional | None | $144.54 | $245.47 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,905.46 | $1,905.46 | $2,344.23 |
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 $144.54 Median $245.47 Typical High $446.68 | Professional | None | $144.54 | $245.47 | $446.68 |
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 $69.18 Median $120.23 Typical High $169.82 | Professional | 52 · Reduced service | $69.18 | $120.23 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $47.86 Typical High $69.18 | Professional | 53 · Discontinued | $27.54 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $177.83 Typical High $257.04 | Professional | 54 · Surgery only | $104.71 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $35.48 Typical High $51.29 | Professional | 55 · Aftercare only | $20.89 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $23.99 Typical High $33.88 | Professional | 56 · Pre-op care only | $13.80 | $23.99 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $165.96 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $97.72 | $165.96 | $239.88 |
Where Tennessee sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$324
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.