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 $1,621.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,621.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,479.11 | Professional | None | $977.24 | $1,023.29 | $1,479.11 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,288.25 Median $2,884.03 Typical High $6,309.57 | Facility | None | $1,288.25 | $2,884.03 | $6,309.57 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,380.38 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,818.38 Typical High $5,888.44 | Facility | None | $602.56 | $2,818.38 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $2,041.74 | Professional | None | $933.25 | $1,174.90 | $2,041.74 |
Lucent Health Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,456.54 | Facility | None | $1,202.26 | $3,801.89 | $6,456.54 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $2,238.72 | Professional | None | $954.99 | $1,412.54 | $2,238.72 |
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 $489.78 Median $512.86 Typical High $741.31 | Professional | 52 · Reduced service | $489.78 | $512.86 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $295.12 | Professional | 53 · Discontinued | $194.98 | $204.17 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $758.58 Typical High $1,096.48 | Professional | 54 · Surgery only | $741.31 | $758.58 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $151.36 Typical High $218.78 | Professional | 55 · Aftercare only | $147.91 | $151.36 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $147.91 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $707.95 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $691.83 | $707.95 | $1,023.29 |
Where Tennessee sits
The same service costs 5.6 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· 13th of 51
$1,905
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.