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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $199.53 | Professional | None | $102.33 | $138.04 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $302.00 | Professional | None | $117.49 | $162.18 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $245.47 | Professional | None | $100.00 | $141.25 | $245.47 |
Lucent Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,047.13 | $1,258.93 |
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 $100.00 Median $162.18 Typical High $281.84 | Professional | None | $100.00 | $162.18 | $281.84 |
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 $51.29 Median $67.61 Typical High $100.00 | Professional | 52 · Reduced service | $51.29 | $67.61 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.92 Typical High $39.81 | Professional | 53 · Discontinued | $20.42 | $26.92 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $102.33 Typical High $151.36 | Professional | 54 · Surgery only | $75.86 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $20.42 Typical High $30.20 | Professional | 55 · Aftercare only | $15.14 | $20.42 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.23 | $13.49 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $95.50 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $70.79 | $95.50 | $141.25 |
Where Tennessee sits
The same service costs 4.2 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· 14th of 51
$191
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.