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 $2,454.71 Median $3,090.30 Typical High $7,585.78 | Facility | None | $2,454.71 | $3,090.30 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,548.82 | $2,398.83 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $5,128.61 | Facility | None | $1,122.02 | $2,137.96 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $3,630.78 | Professional | None | $1,548.82 | $2,238.72 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,041.74 Typical High $3,801.89 | Facility | None | $831.76 | $2,041.74 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,778.28 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $12,589.25 | Professional | None | $10,964.78 | $10,964.78 | $12,589.25 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $3,162.28 | Professional | None | $1,230.27 | $1,584.89 | $3,162.28 |
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 $676.08 Median $724.44 Typical High $977.24 | Professional | 52 · Reduced service | $676.08 | $724.44 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $288.40 Typical High $389.05 | Professional | 53 · Discontinued | $269.15 | $288.40 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,071.52 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,023.29 | $1,071.52 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $213.80 Typical High $295.12 | Professional | 55 · Aftercare only | $204.17 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $144.54 Typical High $194.98 | Professional | 56 · Pre-op care only | $134.90 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,000.00 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $954.99 | $1,000.00 | $1,348.96 |
Where Tennessee sits
The same service costs 15.8 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· 19th of 51
$2,042
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.