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 $4,168.69 Typical High $7,585.78 | Facility | None | $2,454.71 | $4,168.69 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,698.24 | $2,511.89 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $10,471.29 | Facility | None | $1,621.81 | $4,897.79 | $10,471.29 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,698.24 Median $2,454.71 Typical High $3,890.45 | Professional | None | $1,698.24 | $2,454.71 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $10,000.00 Typical High $20,417.38 | Facility | None | $602.56 | $10,000.00 | $20,417.38 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,513.56 | $1,949.84 | $2,754.23 |
Lucent Health Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $12,882.50 | Professional | None | $11,748.98 | $11,748.98 | $12,882.50 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $10,000.00 Typical High $15,848.93 | Facility | None | $3,630.78 | $10,000.00 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,819.70 | $3,388.44 |
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 $724.44 Median $758.58 Typical High $1,047.13 | Professional | 52 · Reduced service | $724.44 | $758.58 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $416.87 | Professional | 53 · Discontinued | $288.40 | $302.00 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,148.15 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $229.09 Typical High $309.03 | Professional | 55 · Aftercare only | $213.80 | $229.09 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $208.93 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,445.44 |
Where Tennessee sits
The same service costs 17.0 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
$2,951
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.