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 $3,090.30 Typical High $7,585.78 | Facility | None | $2,454.71 | $3,090.30 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,479.11 | $1,737.80 | $2,630.27 |
BCBS Tennessee Setting Facility Modifier None Typical Low $2,041.74 Median $3,981.07 Typical High $8,317.64 | Facility | None | $2,041.74 | $3,981.07 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $3,981.07 | Professional | None | $1,621.81 | $2,344.23 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,801.89 Typical High $7,943.28 | Facility | None | $588.84 | $3,801.89 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,584.89 | $1,995.26 | $2,754.23 |
Lucent Health Setting Professional Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $15,848.93 | Professional | None | $15,135.61 | $15,135.61 | $15,848.93 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $3,548.13 | Professional | None | $1,348.96 | $1,737.80 | $3,548.13 |
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 $741.31 Median $812.83 Typical High $1,096.48 | Professional | 52 · Reduced service | $741.31 | $812.83 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $323.59 Typical High $436.52 | Professional | 53 · Discontinued | $295.12 | $323.59 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,202.26 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,122.02 | $1,202.26 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $239.88 Typical High $323.59 | Professional | 55 · Aftercare only | $223.87 | $239.88 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $162.18 Typical High $218.78 | Professional | 56 · Pre-op care only | $147.91 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,122.02 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,122.02 | $1,513.56 |
Where Tennessee sits
The same service costs 11.2 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· 16th of 51
$2,754
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.