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 $602.56 Median $2,290.87 Typical High $7,585.78 | Facility | None | $602.56 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $389.05 | Professional | None | $181.97 | $257.04 | $389.05 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $630.96 | Professional | None | $251.19 | $363.08 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $1,659.59 | Facility | None | $389.05 | $831.76 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $512.86 | Professional | None | $186.21 | $281.84 | $512.86 |
Lucent Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,995.26 | $1,995.26 | $2,398.83 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $588.84 | Professional | None | $213.80 | $346.74 | $588.84 |
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 $125.89 Typical High $186.21 | Professional | 52 · Reduced service | $91.20 | $125.89 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $51.29 Typical High $75.86 | Professional | 53 · Discontinued | $36.31 | $51.29 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $190.55 Typical High $281.84 | Professional | 54 · Surgery only | $138.04 | $190.55 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $38.02 Typical High $56.23 | Professional | 55 · Aftercare only | $27.54 | $38.02 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $25.70 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.20 | $25.70 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $177.83 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $128.82 | $177.83 | $263.03 |
Where Tennessee sits
The same service costs 4.3 times more in Alaska 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· 12th of 51
$447
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.