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 $199.53 Median $316.23 Typical High $478.63 | Professional | None | $199.53 | $316.23 | $478.63 |
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 $213.80 Median $323.59 Typical High $537.03 | Professional | None | $213.80 | $323.59 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $562.34 Typical High $2,691.53 | Facility | None | $295.12 | $562.34 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $457.09 | Professional | None | $204.17 | $323.59 | $457.09 |
Lucent Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,311.31 | Professional | None | $2,511.89 | $2,511.89 | $3,311.31 |
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 $208.93 Median $323.59 Typical High $537.03 | Professional | None | $208.93 | $323.59 | $537.03 |
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 $100.00 Median $158.49 Typical High $239.88 | Professional | 52 · Reduced service | $100.00 | $158.49 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $63.10 Typical High $95.50 | Professional | 53 · Discontinued | $39.81 | $63.10 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $239.88 Typical High $363.08 | Professional | 54 · Surgery only | $147.91 | $239.88 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $47.86 Typical High $72.44 | Professional | 55 · Aftercare only | $29.51 | $47.86 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $31.62 Typical High $47.86 | Professional | 56 · Pre-op care only | $19.95 | $31.62 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $223.87 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $138.04 | $223.87 | $338.84 |
Where Tennessee sits
The same service costs 3.6 times more in Alaska than in New Jersey. 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· 35th of 51
$331
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.