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 $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,659.59 | Professional | None | $1,071.52 | $1,122.02 | $1,659.59 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,258.93 | $1,659.59 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,584.89 | $2,290.87 |
Lucent Health Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $10,232.93 | Professional | None | $8,511.38 | $8,511.38 | $10,232.93 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,174.90 | $1,659.59 | $2,691.53 |
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 $537.03 Median $549.54 Typical High $831.76 | Professional | 52 · Reduced service | $537.03 | $549.54 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $338.84 | Professional | 53 · Discontinued | $213.80 | $223.87 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $1,258.93 | Professional | 54 · Surgery only | $794.33 | $831.76 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $165.96 Typical High $251.19 | Professional | 55 · Aftercare only | $158.49 | $165.96 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $165.96 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $1,174.90 |
Where Tennessee sits
The same service costs 6.8 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· 23rd of 51
$1,660
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.