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 $1,148.15 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,258.93 | $1,737.80 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,548.82 Typical High $3,890.45 | Facility | None | $501.19 | $1,548.82 | $3,890.45 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,412.54 | $2,570.40 |
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 $1,202.26 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,348.96 | $2,089.30 |
Lucent Health Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Professional | None | $12,302.69 | $12,302.69 | $12,302.69 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,677.35 Typical High $9,332.54 | Facility | None | $1,548.82 | $4,677.35 | $9,332.54 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,630.27 | Professional | None | $1,122.02 | $1,348.96 | $2,630.27 |
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 $575.44 Median $616.60 Typical High $870.96 | Professional | 52 · Reduced service | $575.44 | $616.60 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $245.47 Typical High $346.74 | Professional | 53 · Discontinued | $229.09 | $245.47 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $933.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $851.14 | $933.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $186.21 Typical High $257.04 | Professional | 55 · Aftercare only | $169.82 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $123.03 Typical High $173.78 | Professional | 56 · Pre-op care only | $114.82 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $870.96 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $794.33 | $870.96 | $1,202.26 |
Where Tennessee sits
The same service costs 26.3 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· 30th of 51
$1,514
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.