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 $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,584.89 | $2,511.89 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,862.09 Median $6,309.57 Typical High $12,022.64 | Facility | None | $1,862.09 | $6,309.57 | $12,022.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $3,890.45 | Professional | None | $1,621.81 | $2,398.83 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $9,772.37 Typical High $19,952.62 | Facility | None | $602.56 | $9,772.37 | $19,952.62 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,479.11 | $1,949.84 | $2,691.53 |
Lucent Health Setting Professional Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $15,135.61 | Professional | None | $15,135.61 | $15,135.61 | $15,135.61 |
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 $1,778.28 Typical High $3,311.31 | Professional | None | $1,348.96 | $1,778.28 | $3,311.31 |
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 $707.95 Median $758.58 Typical High $1,023.29 | Professional | 52 · Reduced service | $707.95 | $758.58 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $302.00 Typical High $407.38 | Professional | 53 · Discontinued | $281.84 | $302.00 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,122.02 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,071.52 | $1,122.02 | $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 $141.25 Median $151.36 Typical High $204.17 | Professional | 56 · Pre-op care only | $141.25 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,047.13 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,047.13 | $1,445.44 |
Where Tennessee sits
The same service costs 20.4 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· 20th of 51
$2,512
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.