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 $398.11 Median $457.09 Typical High $616.60 | Professional | None | $398.11 | $457.09 | $616.60 |
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 $234.42 Median $316.23 Typical High $524.81 | Professional | None | $234.42 | $316.23 | $524.81 |
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 $446.68 Median $512.86 Typical High $724.44 | Professional | None | $446.68 | $512.86 | $724.44 |
Lucent Health Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $16,595.87 | Professional | None | $14,125.38 | $14,125.38 | $16,595.87 |
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 $269.15 Median $467.74 Typical High $776.25 | Professional | None | $269.15 | $467.74 | $776.25 |
4 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 54 · Surgery only Typical Low $295.12 Median $338.84 Typical High $457.09 | Professional | 54 · Surgery only | $295.12 | $338.84 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $67.61 Typical High $91.20 | Professional | 55 · Aftercare only | $58.88 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $44.67 Typical High $61.66 | Professional | 56 · Pre-op care only | $39.81 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $316.23 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $275.42 | $316.23 | $426.58 |
Where Tennessee sits
The same service costs 11.7 times more in New York than in North Carolina. 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· 35th of 51
$562
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.