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 $263.03 Median $1,778.28 Typical High $6,606.93 | Facility | None | $263.03 | $1,778.28 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $398.11 | Professional | None | $173.78 | $263.03 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $407.38 | Professional | None | $331.13 | $354.81 | $407.38 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,258.93 Typical High $2,818.38 | Facility | None | $575.44 | $1,258.93 | $2,818.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $457.09 | Professional | None | $190.55 | $275.42 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $407.38 Typical High $1,659.59 | Facility | None | $269.15 | $407.38 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $398.11 | Professional | None | $204.17 | $275.42 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,041.74 | $2,818.38 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $436.52 | Professional | None | $177.83 | $251.19 | $436.52 |
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 $87.10 Median $131.83 Typical High $194.98 | Professional | 52 · Reduced service | $87.10 | $131.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $52.48 Typical High $79.43 | Professional | 53 · Discontinued | $34.67 | $52.48 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $194.98 Typical High $295.12 | Professional | 54 · Surgery only | $131.83 | $194.98 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $38.90 Typical High $58.88 | Professional | 55 · Aftercare only | $26.30 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.30 Typical High $39.81 | Professional | 56 · Pre-op care only | $17.38 | $26.30 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $181.97 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $123.03 | $181.97 | $275.42 |
Where Tennessee sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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
$295
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.