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 $125.89 Median $169.82 Typical High $239.88 | Professional | None | $125.89 | $169.82 | $239.88 |
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 $154.88 Median $229.09 Typical High $380.19 | Professional | None | $154.88 | $229.09 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $141.25 Typical High $263.03 | Facility | None | $50.12 | $141.25 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $269.15 | Professional | None | $134.90 | $177.83 | $269.15 |
Lucent Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,230.27 | $1,513.56 |
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 $123.03 Median $162.18 Typical High $316.23 | Professional | None | $123.03 | $162.18 | $316.23 |
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 $63.10 Median $85.11 Typical High $109.65 | Professional | 52 · Reduced service | $63.10 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $33.88 Typical High $43.65 | Professional | 53 · Discontinued | $25.12 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $125.89 Typical High $162.18 | Professional | 54 · Surgery only | $95.50 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $25.12 Typical High $33.11 | Professional | 55 · Aftercare only | $19.05 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.98 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.59 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $117.49 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $89.13 | $117.49 | $151.36 |
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· 22nd of 51
$209
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.