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 $2,238.72 Median $2,454.71 Typical High $3,388.44 | Professional | None | $2,238.72 | $2,454.71 | $3,388.44 |
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 $2,290.87 Median $3,090.30 Typical High $5,011.87 | Professional | None | $2,290.87 | $3,090.30 | $5,011.87 |
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 $2,290.87 Median $2,630.27 Typical High $3,981.07 | Professional | None | $2,290.87 | $2,630.27 | $3,981.07 |
Lucent Health Setting Professional Modifier None Typical Low $17,782.79 Median $17,782.79 Typical High $20,892.96 | Professional | None | $17,782.79 | $17,782.79 | $20,892.96 |
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 $2,137.96 Median $2,570.40 Typical High $5,128.61 | Professional | None | $2,137.96 | $2,570.40 | $5,128.61 |
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 $1,122.02 Median $1,230.27 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,122.02 | $1,230.27 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $489.78 Typical High $676.08 | Professional | 53 · Discontinued | $446.68 | $489.78 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,819.70 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,659.59 | $1,819.70 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $363.08 Typical High $501.19 | Professional | 55 · Aftercare only | $331.13 | $363.08 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $245.47 Typical High $338.84 | Professional | 56 · Pre-op care only | $223.87 | $245.47 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,698.24 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,698.24 | $2,344.23 |
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· 25th of 51
$3,090
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.