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 $2,454.71 Median $3,090.30 Typical High $7,585.78 | Facility | None | $2,454.71 | $3,090.30 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,318.26 | $1,862.09 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,513.56 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,698.24 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,548.13 Typical High $6,606.93 | Facility | None | $831.76 | $3,548.13 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,412.54 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $11,220.18 | Professional | None | $9,549.93 | $9,549.93 | $11,220.18 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,584.89 | $2,884.03 |
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 $588.84 Median $616.60 Typical High $933.25 | Professional | 52 · Reduced service | $588.84 | $616.60 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $245.47 Typical High $371.54 | Professional | 53 · Discontinued | $239.88 | $245.47 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $933.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $891.25 | $933.25 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $186.21 Typical High $281.84 | Professional | 55 · Aftercare only | $177.83 | $186.21 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $123.03 Typical High $186.21 | Professional | 56 · Pre-op care only | $120.23 | $123.03 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $870.96 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $831.76 | $870.96 | $1,318.26 |
Where Tennessee sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 10th of 51
$2,630
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.