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 $2,089.30 Median $2,187.76 Typical High $3,467.37 | Professional | None | $2,089.30 | $2,187.76 | $3,467.37 |
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 $2,344.23 Median $3,019.95 Typical High $5,011.87 | Professional | None | $2,344.23 | $3,019.95 | $5,011.87 |
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 $1,949.84 Median $2,818.38 Typical High $4,168.69 | Professional | None | $1,949.84 | $2,818.38 | $4,168.69 |
Lucent Health Setting Professional Modifier None Typical Low $19,054.61 Median $19,054.61 Typical High $19,054.61 | Professional | None | $19,054.61 | $19,054.61 | $19,054.61 |
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 $1,995.26 Median $2,951.21 Typical High $4,897.79 | Professional | None | $1,995.26 | $2,951.21 | $4,897.79 |
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 $1,047.13 Median $1,096.48 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,047.13 | $1,096.48 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $436.52 Typical High $691.83 | Professional | 53 · Discontinued | $416.87 | $436.52 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,659.59 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,548.82 | $1,659.59 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $331.13 Typical High $524.81 | Professional | 55 · Aftercare only | $316.23 | $331.13 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $218.78 Typical High $346.74 | Professional | 56 · Pre-op care only | $208.93 | $218.78 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,548.82 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,548.82 | $2,454.71 |
Where Tennessee sits
The same service costs 5.2 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· 39th of 51
$2,344
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.