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 $89.13 Median $104.71 Typical High $154.88 | Professional | None | $89.13 | $104.71 | $154.88 |
BCBS Tennessee Setting Facility Modifier None Typical Low $398.11 Median $741.31 Typical High $1,862.09 | Facility | None | $398.11 | $741.31 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $263.03 | Professional | None | $109.65 | $162.18 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $186.21 | Facility | None | $50.12 | $100.00 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $190.55 | Professional | None | $97.72 | $128.82 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | None | $912.01 | $912.01 | $1,071.52 |
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 $89.13 Median $120.23 Typical High $223.87 | Professional | None | $89.13 | $120.23 | $223.87 |
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 $44.67 Median $51.29 Typical High $72.44 | Professional | 52 · Reduced service | $44.67 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.42 Typical High $28.84 | Professional | 53 · Discontinued | $17.78 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $75.86 Typical High $107.15 | Professional | 54 · Surgery only | $66.07 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.14 Typical High $21.88 | Professional | 55 · Aftercare only | $13.18 | $15.14 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.23 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.91 | $10.23 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $70.79 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $61.66 | $70.79 | $100.00 |
Where Tennessee sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 23rd of 51
$148
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.