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 $269.15 Median $323.59 Typical High $489.78 | Professional | None | $269.15 | $323.59 | $489.78 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $758.58 | Professional | None | $316.23 | $457.09 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $302.00 Typical High $1,659.59 | Facility | None | $154.88 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $537.03 | Professional | None | $281.84 | $363.08 | $537.03 |
Lucent Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,235.94 | Professional | None | $2,454.71 | $2,454.71 | $3,235.94 |
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 $251.19 Median $331.13 Typical High $645.65 | Professional | None | $251.19 | $331.13 | $645.65 |
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 $131.83 Median $151.36 Typical High $204.17 | Professional | 52 · Reduced service | $131.83 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $81.28 | Professional | 53 · Discontinued | $53.70 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $229.09 Typical High $309.03 | Professional | 54 · Surgery only | $199.53 | $229.09 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $45.71 Typical High $61.66 | Professional | 55 · Aftercare only | $39.81 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $40.74 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $213.80 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $186.21 | $213.80 | $288.40 |
Where Tennessee sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 22nd of 51
$407
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.