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 $1,819.70 Median $2,951.21 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,951.21 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,380.38 | $2,089.30 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,513.56 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,202.26 | $1,698.24 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,548.13 Typical High $6,606.93 | Facility | None | $831.76 | $3,548.13 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,445.44 | $2,511.89 |
Lucent Health Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $14,125.38 | Professional | None | $10,964.78 | $10,964.78 | $14,125.38 |
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 $1,122.02 Median $1,737.80 Typical High $3,162.28 | Professional | None | $1,122.02 | $1,737.80 | $3,162.28 |
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 $524.81 Median $691.83 Typical High $1,023.29 | Professional | 52 · Reduced service | $524.81 | $691.83 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $275.42 Typical High $407.38 | Professional | 53 · Discontinued | $208.93 | $275.42 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,023.29 Typical High $1,513.56 | Professional | 54 · Surgery only | $794.33 | $1,023.29 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $208.93 Typical High $309.03 | Professional | 55 · Aftercare only | $158.49 | $208.93 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $138.04 Typical High $204.17 | Professional | 56 · Pre-op care only | $104.71 | $138.04 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $954.99 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $741.31 | $954.99 | $1,412.54 |
Where Tennessee sits
The same service costs 5.2 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· 18th of 51
$2,042
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.