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 $97.72 Median $162.18 Typical High $251.19 | Professional | None | $97.72 | $162.18 | $251.19 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $371.54 | Professional | None | $117.49 | $199.53 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $154.88 Typical High $288.40 | Facility | None | $50.12 | $154.88 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $323.59 | Professional | None | $102.33 | $169.82 | $323.59 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,318.26 | $1,621.81 |
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 $102.33 Median $186.21 Typical High $354.81 | Professional | None | $102.33 | $186.21 | $354.81 |
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 $46.77 Median $81.28 Typical High $109.65 | Professional | 52 · Reduced service | $46.77 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $32.36 Typical High $44.67 | Professional | 53 · Discontinued | $18.62 | $32.36 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $120.23 Typical High $165.96 | Professional | 54 · Surgery only | $70.79 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $23.99 Typical High $33.11 | Professional | 55 · Aftercare only | $14.13 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $16.22 Typical High $22.39 | Professional | 56 · Pre-op care only | $9.33 | $16.22 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $112.20 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $66.07 | $112.20 | $154.88 |
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· 14th of 51
$224
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.