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 $1,949.84 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,949.84 | $2,089.30 | $3,311.31 |
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 $2,238.72 Median $2,884.03 Typical High $4,786.30 | Professional | None | $2,238.72 | $2,884.03 | $4,786.30 |
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 $1,819.70 Median $2,630.27 Typical High $3,890.45 | Professional | None | $1,819.70 | $2,630.27 | $3,890.45 |
Lucent Health Setting Professional Modifier None Typical Low $20,417.38 Median $20,417.38 Typical High $20,417.38 | Professional | None | $20,417.38 | $20,417.38 | $20,417.38 |
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 $1,949.84 Median $2,818.38 Typical High $4,570.88 | Professional | None | $1,949.84 | $2,818.38 | $4,570.88 |
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 $977.24 Median $1,047.13 Typical High $1,621.81 | Professional | 52 · Reduced service | $977.24 | $1,047.13 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $416.87 Typical High $660.69 | Professional | 53 · Discontinued | $398.11 | $416.87 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,548.82 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,479.11 | $1,548.82 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $316.23 Typical High $489.78 | Professional | 55 · Aftercare only | $295.12 | $316.23 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $208.93 Typical High $331.13 | Professional | 56 · Pre-op care only | $194.98 | $208.93 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,445.44 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,445.44 | $2,290.87 |
Where Tennessee sits
The same service costs 5.4 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· 38th of 51
$2,291
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.