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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,148.15 | Professional | None | $602.56 | $776.25 | $1,148.15 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,412.54 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,412.54 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,513.56 | Professional | None | $645.65 | $870.96 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,311.31 Typical High $6,606.93 | Facility | None | $741.31 | $3,311.31 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,202.26 | Professional | None | $616.60 | $794.33 | $1,202.26 |
Lucent Health Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $7,413.10 | Professional | None | $6,165.95 | $6,165.95 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,479.11 | Professional | None | $630.96 | $812.83 | $1,479.11 |
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 $302.00 Median $389.05 Typical High $575.44 | Professional | 52 · Reduced service | $302.00 | $389.05 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $154.88 Typical High $229.09 | Professional | 53 · Discontinued | $120.23 | $154.88 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $588.84 Typical High $870.96 | Professional | 54 · Surgery only | $446.68 | $588.84 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $117.49 Typical High $173.78 | Professional | 55 · Aftercare only | $89.13 | $117.49 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $77.62 Typical High $114.82 | Professional | 56 · Pre-op care only | $60.26 | $77.62 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $549.54 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $416.87 | $549.54 | $812.83 |
Where Tennessee sits
The same service costs 4.4 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· 31st of 51
$912
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.