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 $4,168.69 Typical High $7,585.78 | Facility | None | $2,454.71 | $4,168.69 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $426.58 Typical High $1,230.27 | Professional | None | $416.87 | $426.58 | $1,230.27 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,513.56 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $1,096.48 | Professional | None | $446.68 | $602.56 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $3,715.35 Typical High $6,760.83 | Facility | None | $1,479.11 | $3,715.35 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $870.96 | Professional | None | $398.11 | $501.19 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,388.44 | Professional | None | $3,162.28 | $3,162.28 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $954.99 | Professional | None | $398.11 | $588.84 | $954.99 |
7 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 $208.93 Median $213.80 Typical High $309.03 | Professional | 52 · Reduced service | $208.93 | $213.80 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $85.11 Typical High $125.89 | Professional | 53 · Discontinued | $83.18 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $323.59 Typical High $467.74 | Professional | 54 · Surgery only | $316.23 | $323.59 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $93.33 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $42.66 Typical High $63.10 | Professional | 56 · Pre-op care only | $41.69 | $42.66 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $302.00 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $295.12 | $302.00 | $436.52 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 50 · Both sides | $891.25 | $891.25 | $891.25 |
Where Tennessee sits
The same service costs 9.5 times more in Oklahoma 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· 5th of 51
$2,089
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.