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 $295.12 Median $2,818.38 Typical High $7,585.78 | Facility | None | $295.12 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $251.19 Typical High $426.58 | Professional | None | $123.03 | $251.19 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $426.58 | Professional | None | $251.19 | $338.84 | $426.58 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $151.36 Median $323.59 Typical High $776.25 | Professional | None | $151.36 | $323.59 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $131.83 Typical High $245.47 | Facility | None | $50.12 | $131.83 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $281.84 Typical High $436.52 | Professional | None | $131.83 | $281.84 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,235.94 | Professional | None | $2,398.83 | $2,398.83 | $3,235.94 |
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 $128.82 Median $245.47 Typical High $467.74 | Professional | None | $128.82 | $245.47 | $467.74 |
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 $61.66 Median $112.20 Typical High $208.93 | Professional | 52 · Reduced service | $61.66 | $112.20 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $45.71 Typical High $85.11 | Professional | 53 · Discontinued | $24.55 | $45.71 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $169.82 Typical High $316.23 | Professional | 54 · Surgery only | $93.33 | $169.82 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $33.88 Typical High $63.10 | Professional | 55 · Aftercare only | $18.62 | $33.88 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $22.91 Typical High $42.66 | Professional | 56 · Pre-op care only | $12.30 | $22.91 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $158.49 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $87.10 | $158.49 | $295.12 |
Where Tennessee sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 17th of 51
$309
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.