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 $97.72 Median $134.90 Typical High $199.53 | Professional | None | $97.72 | $134.90 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $147.91 | Professional | None | $128.82 | $144.54 | $147.91 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $251.19 | Professional | None | $104.71 | $151.36 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $223.87 Typical High $1,659.59 | Facility | None | $112.20 | $223.87 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $208.93 | Professional | None | $102.33 | $134.90 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,047.13 | $1,288.25 |
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 $102.33 Median $141.25 Typical High $251.19 | Professional | None | $102.33 | $141.25 | $251.19 |
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 $48.98 Median $66.07 Typical High $100.00 | Professional | 52 · Reduced service | $48.98 | $66.07 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $26.92 Typical High $39.81 | Professional | 53 · Discontinued | $19.50 | $26.92 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $100.00 Typical High $151.36 | Professional | 54 · Surgery only | $72.44 | $100.00 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $19.95 Typical High $30.20 | Professional | 55 · Aftercare only | $14.45 | $19.95 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $13.18 Typical High $19.95 | Professional | 56 · Pre-op care only | $9.77 | $13.18 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $93.33 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $67.61 | $93.33 | $141.25 |
Where Tennessee sits
The same service costs 4.0 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· 33rd of 51
$155
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.