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 $1,621.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,621.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,318.26 | Professional | None | $741.31 | $870.96 | $1,318.26 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,089.30 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $2,041.74 | Professional | None | $870.96 | $1,258.93 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,454.71 Typical High $4,466.84 | Facility | None | $602.56 | $2,454.71 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,412.54 | Professional | None | $776.25 | $1,000.00 | $1,412.54 |
Lucent Health Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,918.31 | Professional | None | $6,165.95 | $6,165.95 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,230.27 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,778.28 | Professional | None | $707.95 | $933.25 | $1,778.28 |
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 $371.54 Median $398.11 Typical High $549.54 | Professional | 52 · Reduced service | $371.54 | $398.11 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $218.78 | Professional | 53 · Discontinued | $151.36 | $158.49 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $812.83 | Professional | 54 · Surgery only | $562.34 | $588.84 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $162.18 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $109.65 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $758.58 |
Where Tennessee sits
The same service costs 7.9 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· 11th of 51
$1,514
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.