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 $1,202.26 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,318.26 | $1,819.70 |
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 $1,230.27 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,513.56 | $2,691.53 |
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 $1,258.93 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,412.54 | $2,187.76 |
Lucent Health Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $11,220.18 | Professional | None | $9,549.93 | $9,549.93 | $11,220.18 |
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 $1,148.15 Median $1,380.38 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,380.38 | $2,754.23 |
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 $602.56 Median $660.69 Typical High $912.01 | Professional | 52 · Reduced service | $602.56 | $660.69 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $263.03 Typical High $363.08 | Professional | 53 · Discontinued | $239.88 | $263.03 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $977.24 Typical High $1,380.38 | Professional | 54 · Surgery only | $912.01 | $977.24 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $199.53 Typical High $275.42 | Professional | 55 · Aftercare only | $181.97 | $199.53 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $131.83 Typical High $181.97 | Professional | 56 · Pre-op care only | $120.23 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $912.01 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $851.14 | $912.01 | $1,288.25 |
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· 27th of 51
$1,660
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.