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 $812.83 Median $2,398.83 Typical High $7,585.78 | Facility | None | $812.83 | $2,398.83 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $562.34 | Professional | None | $257.04 | $389.05 | $562.34 |
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 $323.59 Median $562.34 Typical High $1,023.29 | Professional | None | $323.59 | $562.34 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $588.84 Typical High $2,691.53 | Facility | None | $309.03 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $676.08 | Professional | None | $269.15 | $398.11 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,715.35 | Professional | None | $3,162.28 | $3,162.28 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $776.25 | Professional | None | $263.03 | $416.87 | $776.25 |
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 $128.82 Median $194.98 Typical High $275.42 | Professional | 52 · Reduced service | $128.82 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $77.62 Typical High $112.20 | Professional | 53 · Discontinued | $51.29 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $288.40 Typical High $416.87 | Professional | 54 · Surgery only | $190.55 | $288.40 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $57.54 Typical High $83.18 | Professional | 55 · Aftercare only | $38.02 | $57.54 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $38.90 Typical High $56.23 | Professional | 56 · Pre-op care only | $25.70 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $269.15 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $177.83 | $269.15 | $389.05 |
Where Tennessee sits
The same service costs 4.7 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· 15th of 51
$525
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.