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 $213.80 Median $2,818.38 Typical High $7,585.78 | Facility | None | $213.80 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $269.15 | Professional | None | $109.65 | $177.83 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $416.87 | Professional | None | $120.23 | $208.93 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $354.81 | Professional | None | $112.20 | $190.55 | $354.81 |
Lucent Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,479.11 | $1,479.11 | $1,862.09 |
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 $109.65 Median $208.93 Typical High $389.05 | Professional | None | $109.65 | $208.93 | $389.05 |
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 $52.48 Median $89.13 Typical High $123.03 | Professional | 52 · Reduced service | $52.48 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $35.48 Typical High $48.98 | Professional | 53 · Discontinued | $20.89 | $35.48 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $134.90 Typical High $186.21 | Professional | 54 · Surgery only | $79.43 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $26.92 Typical High $37.15 | Professional | 55 · Aftercare only | $15.85 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $17.78 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.47 | $17.78 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $125.89 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $74.13 | $125.89 | $173.78 |
Where Tennessee sits
The same service costs 4.5 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· 15th of 51
$245
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.