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 $4,168.69 Typical High $35,481.34 | Facility | None | $2,454.71 | $4,168.69 | $35,481.34 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,659.59 | $1,995.26 | $2,884.03 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,905.46 Median $5,011.87 Typical High $10,964.78 | Facility | None | $1,905.46 | $5,011.87 | $10,964.78 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,905.46 Median $2,818.38 Typical High $4,466.84 | Professional | None | $1,905.46 | $2,818.38 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $10,000.00 Typical High $20,417.38 | Facility | None | $602.56 | $10,000.00 | $20,417.38 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $3,162.28 | Professional | None | $1,737.80 | $2,238.72 | $3,162.28 |
Lucent Health Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $17,378.01 | Professional | None | $14,125.38 | $14,125.38 | $17,378.01 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $10,232.93 Typical High $20,892.96 | Facility | None | $3,630.78 | $10,232.93 | $20,892.96 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $3,981.07 | Professional | None | $1,513.56 | $2,041.74 | $3,981.07 |
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 $831.76 Median $891.25 Typical High $1,230.27 | Professional | 52 · Reduced service | $831.76 | $891.25 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $354.81 Typical High $489.78 | Professional | 53 · Discontinued | $331.13 | $354.81 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,348.96 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,230.27 | $1,348.96 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $269.15 Typical High $371.54 | Professional | 55 · Aftercare only | $251.19 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $177.83 Typical High $245.47 | Professional | 56 · Pre-op care only | $165.96 | $177.83 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,258.93 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,258.93 | $1,737.80 |
Where Tennessee sits
The same service costs 16.2 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· 11th of 51
$3,388
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.