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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $416.87 | Professional | None | $181.97 | $269.15 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $660.69 | Professional | None | $239.88 | $354.81 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $537.03 Typical High $2,187.76 | Facility | None | $331.13 | $537.03 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $524.81 | Professional | None | $186.21 | $281.84 | $524.81 |
Lucent Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,630.27 | Professional | None | $2,137.96 | $2,137.96 | $2,630.27 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $630.96 | Professional | None | $208.93 | $346.74 | $630.96 |
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 $91.20 Median $134.90 Typical High $204.17 | Professional | 52 · Reduced service | $91.20 | $134.90 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $53.70 Typical High $81.28 | Professional | 53 · Discontinued | $36.31 | $53.70 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $199.53 Typical High $302.00 | Professional | 54 · Surgery only | $134.90 | $199.53 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $39.81 Typical High $60.26 | Professional | 55 · Aftercare only | $26.92 | $39.81 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $26.92 Typical High $40.74 | Professional | 56 · Pre-op care only | $18.20 | $26.92 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $186.21 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $125.89 | $186.21 | $281.84 |
Where Tennessee sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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· 14th of 51
$407
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.