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 $891.25 Median $1,047.13 Typical High $1,548.82 | Professional | None | $891.25 | $1,047.13 | $1,548.82 |
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 $1,071.52 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,513.56 | $2,398.83 |
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 $933.25 Median $1,174.90 Typical High $1,778.28 | Professional | None | $933.25 | $1,174.90 | $1,778.28 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $8,128.31 | Professional | None | $7,413.10 | $7,413.10 | $8,128.31 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $2,137.96 | Professional | None | $851.14 | $1,122.02 | $2,137.96 |
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 $446.68 Median $478.63 Typical High $660.69 | Professional | 52 · Reduced service | $446.68 | $478.63 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $263.03 | Professional | 53 · Discontinued | $177.83 | $190.55 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $1,000.00 | Professional | 54 · Surgery only | $660.69 | $707.95 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $141.25 Typical High $199.53 | Professional | 55 · Aftercare only | $134.90 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $131.83 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $933.25 |
Where Tennessee sits
The same service costs 8.3 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
$1,820
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.