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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $363.08 | Professional | None | $208.93 | $234.42 | $363.08 |
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 $239.88 Median $354.81 Typical High $562.34 | Professional | None | $239.88 | $354.81 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,047.13 Typical High $1,905.46 | Facility | None | $389.05 | $1,047.13 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $398.11 | Professional | None | $223.87 | $275.42 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,819.70 | $1,819.70 | $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 $190.55 Median $251.19 Typical High $489.78 | Professional | None | $190.55 | $251.19 | $489.78 |
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 $104.71 Median $114.82 Typical High $151.36 | Professional | 52 · Reduced service | $104.71 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $45.71 Typical High $60.26 | Professional | 53 · Discontinued | $42.66 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $173.78 Typical High $229.09 | Professional | 54 · Surgery only | $158.49 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $34.67 Typical High $45.71 | Professional | 55 · Aftercare only | $31.62 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.91 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.89 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $162.18 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $147.91 | $162.18 | $213.80 |
Where Tennessee sits
The same service costs 5.4 times more in Alaska than in Utah. 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
$355
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.