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 $1,819.70 Median $3,388.44 Typical High $7,244.36 | Facility | None | $1,819.70 | $3,388.44 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,698.24 | $2,570.40 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,318.26 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,737.80 Median $2,511.89 Typical High $3,981.07 | Professional | None | $1,737.80 | $2,511.89 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,365.16 Typical High $7,943.28 | Facility | None | $588.84 | $4,365.16 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,513.56 | $1,995.26 | $2,818.38 |
Lucent Health Setting Professional Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $13,182.57 | Professional | None | $12,589.25 | $12,589.25 | $13,182.57 |
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 $1,380.38 Median $1,862.09 Typical High $3,467.37 | Professional | None | $1,380.38 | $1,862.09 | $3,467.37 |
4 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 54 · Surgery only Typical Low $1,096.48 Median $1,174.90 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,096.48 | $1,174.90 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $234.42 Typical High $316.23 | Professional | 55 · Aftercare only | $218.78 | $234.42 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $154.88 Typical High $208.93 | Professional | 56 · Pre-op care only | $144.54 | $154.88 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,096.48 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,096.48 | $1,479.11 |
Where Tennessee sits
The same service costs 7.8 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· 13th of 51
$2,692
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.