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 $446.68 Median $2,818.38 Typical High $6,606.93 | Facility | None | $446.68 | $2,818.38 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $446.68 Typical High $891.25 | Professional | None | $257.04 | $446.68 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $512.86 | Professional | None | $338.84 | $457.09 | $512.86 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $389.05 Median $676.08 Typical High $1,071.52 | Professional | None | $389.05 | $676.08 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $501.19 Typical High $2,691.53 | Facility | None | $251.19 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $489.78 Typical High $1,000.00 | Professional | None | $281.84 | $489.78 | $1,000.00 |
Lucent Health 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 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $354.81 Median $630.96 Typical High $1,000.00 | Professional | None | $354.81 | $630.96 | $1,000.00 |
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 $128.82 Median $213.80 Typical High $354.81 | Professional | 52 · Reduced service | $128.82 | $213.80 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $85.11 Typical High $141.25 | Professional | 53 · Discontinued | $52.48 | $85.11 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $316.23 Typical High $537.03 | Professional | 54 · Surgery only | $194.98 | $316.23 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $64.57 Typical High $107.15 | Professional | 55 · Aftercare only | $38.90 | $64.57 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $42.66 Typical High $70.79 | Professional | 56 · Pre-op care only | $25.70 | $42.66 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $295.12 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $181.97 | $295.12 | $501.19 |
Where Tennessee sits
The same service costs 4.1 times more in Wisconsin 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· 3rd of 51
$871
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.