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 $208.93 Median $1,949.84 Typical High $6,606.93 | Facility | None | $208.93 | $1,949.84 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $229.09 | Professional | None | $91.20 | $147.91 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $323.59 | Professional | None | $208.93 | $295.12 | $323.59 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $302.00 | Professional | None | $109.65 | $162.18 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $1,659.59 | Facility | None | $125.89 | $251.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $281.84 | Professional | None | $102.33 | $169.82 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,318.26 | $1,584.89 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,737.80 | Facility | None | $107.15 | $436.52 | $1,737.80 |
United Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $302.00 | Professional | None | $100.00 | $162.18 | $302.00 |
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 $45.71 Median $72.44 Typical High $104.71 | Professional | 52 · Reduced service | $45.71 | $72.44 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $28.84 Typical High $41.69 | Professional | 53 · Discontinued | $18.20 | $28.84 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $107.15 Typical High $158.49 | Professional | 54 · Surgery only | $69.18 | $107.15 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $21.88 Typical High $31.62 | Professional | 55 · Aftercare only | $13.80 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $20.89 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $100.00 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $64.57 | $100.00 | $147.91 |
Where Tennessee sits
The same service costs 3.6 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· 18th of 51
$204
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.