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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $602.56 | Professional | None | $281.84 | $416.87 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $354.81 Median $602.56 Typical High $1,096.48 | Professional | None | $354.81 | $602.56 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $933.25 Typical High $2,187.76 | Facility | None | $524.81 | $933.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $724.44 | Professional | None | $288.40 | $426.58 | $724.44 |
Lucent Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,890.45 | Professional | None | $3,311.31 | $3,311.31 | $3,890.45 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $831.76 | Professional | None | $295.12 | $446.68 | $831.76 |
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 $141.25 Median $208.93 Typical High $295.12 | Professional | 52 · Reduced service | $141.25 | $208.93 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $83.18 Typical High $120.23 | Professional | 53 · Discontinued | $56.23 | $83.18 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $309.03 Typical High $446.68 | Professional | 54 · Surgery only | $208.93 | $309.03 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $61.66 Typical High $89.13 | Professional | 55 · Aftercare only | $41.69 | $61.66 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $41.69 Typical High $60.26 | Professional | 56 · Pre-op care only | $28.18 | $41.69 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $288.40 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $194.98 | $288.40 | $416.87 |
Where Tennessee sits
The same service costs 4.9 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· 17th of 51
$575
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.