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 $954.99 Median $1,071.52 Typical High $1,698.24 | Professional | None | $954.99 | $1,071.52 | $1,698.24 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,412.54 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,412.54 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,548.82 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,786.30 Typical High $10,232.93 | Facility | None | $588.84 | $4,786.30 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,288.25 | $1,819.70 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $8,912.51 | Professional | None | $7,943.28 | $7,943.28 | $8,912.51 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $2,290.87 | Professional | None | $870.96 | $1,148.15 | $2,290.87 |
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 $478.63 Median $512.86 Typical High $691.83 | Professional | 52 · Reduced service | $478.63 | $512.86 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $275.42 | Professional | 53 · Discontinued | $190.55 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $1,047.13 | Professional | 54 · Surgery only | $724.44 | $758.58 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $208.93 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $138.04 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $977.24 |
Where Tennessee sits
The same service costs 13.8 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· 11th of 51
$1,905
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.