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 $165.96 Median $218.78 Typical High $316.23 | Professional | None | $165.96 | $218.78 | $316.23 |
BCBS Tennessee Setting Facility Modifier None Typical Low $831.76 Median $1,584.89 Typical High $3,467.37 | Facility | None | $831.76 | $1,584.89 | $3,467.37 |
BCBS Tennessee Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $501.19 | Professional | None | $190.55 | $263.03 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,318.26 Typical High $2,454.71 | Facility | None | $389.05 | $1,318.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $389.05 | Professional | None | $158.49 | $229.09 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $457.09 | Professional | None | $165.96 | $263.03 | $457.09 |
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 $83.18 Median $107.15 Typical High $158.49 | Professional | 52 · Reduced service | $83.18 | $107.15 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $42.66 Typical High $64.57 | Professional | 53 · Discontinued | $33.11 | $42.66 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $162.18 Typical High $239.88 | Professional | 54 · Surgery only | $123.03 | $162.18 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $32.36 Typical High $47.86 | Professional | 55 · Aftercare only | $24.55 | $32.36 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $21.38 Typical High $31.62 | Professional | 56 · Pre-op care only | $16.60 | $21.38 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $151.36 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $114.82 | $151.36 | $223.87 |
Where Tennessee sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 12th of 51
$339
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.