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 $173.78 Median $213.80 Typical High $302.00 | Professional | None | $173.78 | $213.80 | $302.00 |
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 $177.83 Median $269.15 Typical High $537.03 | Professional | None | $177.83 | $269.15 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $162.18 Typical High $302.00 | Facility | None | $50.12 | $162.18 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $363.08 | Professional | None | $186.21 | $239.88 | $363.08 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,778.28 | $1,778.28 | $2,344.23 |
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 $144.54 Median $213.80 Typical High $426.58 | Professional | None | $144.54 | $213.80 | $426.58 |
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 $85.11 Median $102.33 Typical High $147.91 | Professional | 52 · Reduced service | $85.11 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $41.69 Typical High $58.88 | Professional | 53 · Discontinued | $34.67 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $154.88 Typical High $218.78 | Professional | 54 · Surgery only | $128.82 | $154.88 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.90 Typical High $43.65 | Professional | 55 · Aftercare only | $25.70 | $30.90 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.42 Typical High $29.51 | Professional | 56 · Pre-op care only | $17.38 | $20.42 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $144.54 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $120.23 | $144.54 | $204.17 |
Where Tennessee sits
The same service costs 5.0 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
$269
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.