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 $128.82 Median $213.80 Typical High $323.59 | Professional | None | $128.82 | $213.80 | $323.59 |
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 $141.25 Median $229.09 Typical High $380.19 | Professional | None | $141.25 | $229.09 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $371.54 Typical High $1,659.59 | Facility | None | $186.21 | $371.54 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $331.13 | Professional | None | $131.83 | $208.93 | $331.13 |
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 $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 $138.04 Median $218.78 Typical High $380.19 | Professional | None | $138.04 | $218.78 | $380.19 |
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 $64.57 Median $107.15 Typical High $162.18 | Professional | 52 · Reduced service | $64.57 | $107.15 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $42.66 Typical High $64.57 | Professional | 53 · Discontinued | $25.70 | $42.66 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $158.49 Typical High $239.88 | Professional | 54 · Surgery only | $97.72 | $158.49 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $31.62 Typical High $47.86 | Professional | 55 · Aftercare only | $19.50 | $31.62 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $21.38 Typical High $32.36 | Professional | 56 · Pre-op care only | $12.88 | $21.38 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $147.91 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $91.20 | $147.91 | $223.87 |
Where Tennessee sits
The same service costs 3.5 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· 30th of 51
$229
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.