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 $1,513.56 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,513.56 | $1,659.59 | $2,290.87 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,862.09 Median $3,981.07 Typical High $8,511.38 | Facility | None | $1,862.09 | $3,981.07 | $8,511.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $3,467.37 | Professional | None | $1,584.89 | $1,905.46 | $3,467.37 |
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 $1,584.89 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,584.89 | $1,778.28 | $2,754.23 |
Lucent Health Setting Professional Modifier None Typical Low $12,022.64 Median $12,022.64 Typical High $13,803.84 | Professional | None | $12,022.64 | $12,022.64 | $13,803.84 |
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 $1,479.11 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,479.11 | $1,819.70 | $3,467.37 |
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 $758.58 Median $831.76 Typical High $1,148.15 | Professional | 52 · Reduced service | $758.58 | $831.76 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $331.13 Typical High $457.09 | Professional | 53 · Discontinued | $302.00 | $331.13 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,230.27 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,148.15 | $1,230.27 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $245.47 Typical High $346.74 | Professional | 55 · Aftercare only | $229.09 | $245.47 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $165.96 Typical High $229.09 | Professional | 56 · Pre-op care only | $151.36 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,148.15 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,148.15 | $1,621.81 |
Where Tennessee sits
The same service costs 5.4 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· 24th of 51
$2,138
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.