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 $977.24 Median $1,096.48 Typical High $1,737.80 | Professional | None | $977.24 | $1,096.48 | $1,737.80 |
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 $1,148.15 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,737.80 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,897.79 Typical High $10,232.93 | Facility | None | $602.56 | $4,897.79 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,318.26 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
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 $912.01 Median $1,202.26 Typical High $2,344.23 | Professional | None | $912.01 | $1,202.26 | $2,344.23 |
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 $489.78 Median $524.81 Typical High $707.95 | Professional | 52 · Reduced service | $489.78 | $524.81 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $208.93 Typical High $288.40 | Professional | 53 · Discontinued | $194.98 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $776.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $741.31 | $776.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $154.88 Typical High $213.80 | Professional | 55 · Aftercare only | $147.91 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $104.71 Typical High $141.25 | Professional | 56 · Pre-op care only | $97.72 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $724.44 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $691.83 | $724.44 | $1,000.00 |
Where Tennessee sits
The same service costs 8.7 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· 10th 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.