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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $199.53 Typical High $295.12 | Professional | None | $100.00 | $199.53 | $295.12 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $112.20 Median $213.80 Typical High $346.74 | Professional | None | $112.20 | $213.80 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $288.40 Typical High $1,659.59 | Facility | None | $147.91 | $288.40 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $199.53 Typical High $281.84 | Professional | None | $107.15 | $199.53 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,621.81 | $1,621.81 | $1,995.26 |
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 $109.65 Median $199.53 Typical High $346.74 | Professional | None | $109.65 | $199.53 | $346.74 |
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 $50.12 Median $97.72 Typical High $147.91 | Professional | 52 · Reduced service | $50.12 | $97.72 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $39.81 Typical High $60.26 | Professional | 53 · Discontinued | $19.95 | $39.81 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $147.91 Typical High $223.87 | Professional | 54 · Surgery only | $74.13 | $147.91 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $29.51 Typical High $44.67 | Professional | 55 · Aftercare only | $15.14 | $29.51 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $19.95 Typical High $29.51 | Professional | 56 · Pre-op care only | $10.00 | $19.95 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $138.04 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $69.18 | $138.04 | $208.93 |
Where Tennessee sits
The same service costs 3.5 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· 25th of 51
$214
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.