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 $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $181.97 | Professional | None | $87.10 | $131.83 | $181.97 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $331.13 | Professional | None | $109.65 | $169.82 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $257.04 Typical High $1,659.59 | Facility | None | $128.82 | $257.04 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $269.15 | Professional | None | $95.50 | $138.04 | $269.15 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,096.48 | $1,348.96 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $302.00 | Professional | None | $93.33 | $154.88 | $302.00 |
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 $43.65 Median $66.07 Typical High $91.20 | Professional | 52 · Reduced service | $43.65 | $66.07 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $26.30 Typical High $36.31 | Professional | 53 · Discontinued | $17.78 | $26.30 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $100.00 Typical High $134.90 | Professional | 54 · Surgery only | $66.07 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.95 Typical High $26.92 | Professional | 55 · Aftercare only | $13.18 | $19.95 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $13.18 Typical High $18.20 | Professional | 56 · Pre-op care only | $8.71 | $13.18 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $93.33 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $61.66 | $93.33 | $125.89 |
Where Tennessee sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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
$219
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.