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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,071.52 | Professional | None | $602.56 | $707.95 | $1,071.52 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,621.81 | Professional | None | $691.83 | $1,000.00 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,047.13 Typical High $1,905.46 | Facility | None | $389.05 | $1,047.13 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,148.15 | Professional | None | $630.96 | $812.83 | $1,148.15 |
Lucent Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,623.41 | Professional | None | $5,011.87 | $5,011.87 | $5,623.41 |
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 $575.44 Median $758.58 Typical High $1,445.44 | Professional | None | $575.44 | $758.58 | $1,445.44 |
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 $302.00 Median $323.59 Typical High $446.68 | Professional | 52 · Reduced service | $302.00 | $323.59 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $128.82 Typical High $177.83 | Professional | 53 · Discontinued | $120.23 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $478.63 Typical High $660.69 | Professional | 54 · Surgery only | $457.09 | $478.63 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $97.72 Typical High $131.83 | Professional | 55 · Aftercare only | $91.20 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $64.57 Typical High $89.13 | Professional | 56 · Pre-op care only | $60.26 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $446.68 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $426.58 | $446.68 | $616.60 |
Where Tennessee sits
The same service costs 8.5 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
$933
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.