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 $2,344.23 Median $4,570.88 Typical High $10,715.19 | Facility | None | $2,344.23 | $4,570.88 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,202.26 | $2,818.38 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,318.26 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,348.96 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,630.78 Typical High $6,606.93 | Facility | None | $1,174.90 | $3,630.78 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,258.93 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $9,120.11 | Professional | None | $8,912.51 | $8,912.51 | $9,120.11 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,288.25 | $2,238.72 |
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 $812.83 | Professional | 52 · Reduced service | $537.03 | $549.54 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $323.59 | Professional | 53 · Discontinued | $213.80 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $1,202.26 | Professional | 54 · Surgery only | $794.33 | $812.83 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $239.88 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $162.18 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $1,122.02 |
Where Tennessee sits
The same service costs 5.5 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· 6th of 51
$2,692
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.