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 $229.09 Median $269.15 Typical High $398.11 | Professional | None | $229.09 | $269.15 | $398.11 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $630.96 | Professional | None | $269.15 | $389.05 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $302.00 Typical High $1,659.59 | Facility | None | $154.88 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $446.68 | Professional | None | $245.47 | $316.23 | $446.68 |
Lucent Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,691.53 | Professional | None | $2,041.74 | $2,041.74 | $2,691.53 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $549.54 | Professional | None | $213.80 | $281.84 | $549.54 |
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 $114.82 Median $128.82 Typical High $169.82 | Professional | 52 · Reduced service | $114.82 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $51.29 Typical High $67.61 | Professional | 53 · Discontinued | $45.71 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $190.55 Typical High $257.04 | Professional | 54 · Surgery only | $173.78 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.02 Typical High $51.29 | Professional | 55 · Aftercare only | $34.67 | $38.02 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $33.88 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $177.83 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $162.18 | $177.83 | $239.88 |
Where Tennessee sits
The same service costs 5.9 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· 23rd of 51
$347
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.