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 $630.96 Median $741.31 Typical High $1,096.48 | Professional | None | $630.96 | $741.31 | $1,096.48 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,318.26 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,698.24 | Professional | None | $724.44 | $1,071.52 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,801.89 Typical High $7,943.28 | Facility | None | $602.56 | $3,801.89 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,202.26 | Professional | None | $660.69 | $851.14 | $1,202.26 |
Lucent Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,888.44 | Professional | None | $5,248.07 | $5,248.07 | $5,888.44 |
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 $602.56 Median $776.25 Typical High $1,479.11 | Professional | None | $602.56 | $776.25 | $1,479.11 |
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 $316.23 Median $331.13 Typical High $457.09 | Professional | 52 · Reduced service | $316.23 | $331.13 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $186.21 | Professional | 53 · Discontinued | $125.89 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $691.83 | Professional | 54 · Surgery only | $467.74 | $501.19 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $138.04 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $67.61 Typical High $93.33 | Professional | 56 · Pre-op care only | $63.10 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $645.65 |
Where Tennessee sits
The same service costs 7.8 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· 8th of 51
$1,445
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.