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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $331.13 | Professional | None | $123.03 | $218.78 | $331.13 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $131.83 Median $229.09 Typical High $380.19 | Professional | None | $131.83 | $229.09 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $398.11 Typical High $1,659.59 | Facility | None | $223.87 | $398.11 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $331.13 | Professional | None | $147.91 | $229.09 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,737.80 | $1,737.80 | $2,344.23 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $371.54 | Professional | None | $128.82 | $218.78 | $371.54 |
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 $61.66 Median $109.65 Typical High $162.18 | Professional | 52 · Reduced service | $61.66 | $109.65 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $43.65 Typical High $66.07 | Professional | 53 · Discontinued | $24.55 | $43.65 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $162.18 Typical High $245.47 | Professional | 54 · Surgery only | $91.20 | $162.18 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $32.36 Typical High $48.98 | Professional | 55 · Aftercare only | $18.20 | $32.36 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $21.88 Typical High $33.11 | Professional | 56 · Pre-op care only | $12.30 | $21.88 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $151.36 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $85.11 | $151.36 | $229.09 |
Where Tennessee sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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
$245
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.