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 $371.54 Median $407.38 Typical High $575.44 | Professional | None | $371.54 | $407.38 | $575.44 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $831.76 | Professional | None | $371.54 | $457.09 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $154.88 Typical High $288.40 | Facility | None | $50.12 | $154.88 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $660.69 | Professional | None | $371.54 | $389.05 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,090.30 | Professional | None | $3,019.95 | $3,019.95 | $3,090.30 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $851.14 | Professional | None | $363.08 | $426.58 | $851.14 |
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 $186.21 Median $199.53 Typical High $281.84 | Professional | 52 · Reduced service | $186.21 | $199.53 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $112.20 | Professional | 53 · Discontinued | $74.13 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $302.00 Typical High $416.87 | Professional | 54 · Surgery only | $275.42 | $302.00 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $60.26 Typical High $83.18 | Professional | 55 · Aftercare only | $54.95 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $39.81 Typical High $56.23 | Professional | 56 · Pre-op care only | $37.15 | $39.81 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $281.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $257.04 | $281.84 | $389.05 |
Where Tennessee sits
The same service costs 4.2 times more in Wyoming than in Utah. 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· 25th of 51
$513
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.