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 $1,905.46 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,905.46 | $2,041.74 | $3,162.28 |
Ambetter Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
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 $2,187.76 Median $2,818.38 Typical High $4,677.35 | Professional | None | $2,187.76 | $2,818.38 | $4,677.35 |
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 $1,778.28 Median $2,630.27 Typical High $3,801.89 | Professional | None | $1,778.28 | $2,630.27 | $3,801.89 |
Lucent Health Setting Professional Modifier None Typical Low $19,952.62 Median $20,417.38 Typical High $20,417.38 | Professional | None | $19,952.62 | $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 $1,905.46 Median $2,951.21 Typical High $4,570.88 | Professional | None | $1,905.46 | $2,951.21 | $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 $954.99 Median $1,023.29 Typical High $1,584.89 | Professional | 52 · Reduced service | $954.99 | $1,023.29 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $407.38 Typical High $645.65 | Professional | 53 · Discontinued | $380.19 | $407.38 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,513.56 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,445.44 | $1,513.56 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $302.00 Typical High $478.63 | Professional | 55 · Aftercare only | $288.40 | $302.00 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $204.17 Typical High $316.23 | Professional | 56 · Pre-op care only | $190.55 | $204.17 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,412.54 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,412.54 | $2,238.72 |
Where Tennessee sits
The same service costs 5.8 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· 35th of 51
$2,399
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.