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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,348.96 | $1,862.09 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,548.82 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,479.11 | $2,290.87 |
Lucent Health Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $11,481.54 | Professional | None | $9,772.37 | $9,772.37 | $11,481.54 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,479.11 | $2,818.38 |
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 $616.60 Median $676.08 Typical High $933.25 | Professional | 52 · Reduced service | $616.60 | $676.08 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $269.15 Typical High $371.54 | Professional | 53 · Discontinued | $251.19 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,023.29 Typical High $1,412.54 | Professional | 54 · Surgery only | $933.25 | $1,023.29 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $281.84 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $186.21 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $1,318.26 |
Where Tennessee sits
The same service costs 5.5 times more in Alaska than in Texas. 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· 26th of 51
$1,698
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.