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 $208.93 Median $1,949.84 Typical High $6,606.93 | Facility | None | $208.93 | $1,949.84 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $309.03 | Professional | None | $117.49 | $208.93 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
BCBS Tennessee Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $5,128.61 | Facility | None | $933.25 | $1,905.46 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $354.81 | Professional | None | $125.89 | $213.80 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $380.19 Typical High $1,659.59 | Facility | None | $190.55 | $380.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $288.40 | Professional | None | $120.23 | $204.17 | $288.40 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,621.81 | $1,949.84 |
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 $123.03 Median $199.53 Typical High $346.74 | Professional | None | $123.03 | $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 $57.54 Median $102.33 Typical High $154.88 | Professional | 52 · Reduced service | $57.54 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $41.69 Typical High $63.10 | Professional | 53 · Discontinued | $23.44 | $41.69 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $154.88 Typical High $234.42 | Professional | 54 · Surgery only | $87.10 | $154.88 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $30.90 Typical High $46.77 | Professional | 55 · Aftercare only | $17.38 | $30.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $20.89 Typical High $30.90 | Professional | 56 · Pre-op care only | $11.75 | $20.89 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $144.54 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $81.28 | $144.54 | $218.78 |
Where Tennessee sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 32nd 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.