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 $602.56 Median $2,290.87 Typical High $7,585.78 | Facility | None | $602.56 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $316.23 | Professional | None | $154.88 | $213.80 | $316.23 |
BCBS Tennessee Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $5,128.61 | Facility | None | $933.25 | $1,905.46 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $478.63 | Professional | None | $199.53 | $269.15 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,778.28 Typical High $3,801.89 | Facility | None | $389.05 | $1,778.28 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $407.38 | Professional | None | $173.78 | $234.42 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $446.68 | Professional | None | $173.78 | $257.04 | $446.68 |
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 $77.62 Median $104.71 Typical High $144.54 | Professional | 52 · Reduced service | $77.62 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $41.69 Typical High $57.54 | Professional | 53 · Discontinued | $30.90 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $158.49 Typical High $213.80 | Professional | 54 · Surgery only | $117.49 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $31.62 Typical High $42.66 | Professional | 55 · Aftercare only | $23.44 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.89 Typical High $28.84 | Professional | 56 · Pre-op care only | $15.49 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $147.91 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $109.65 | $147.91 | $199.53 |
Where Tennessee sits
The same service costs 4.4 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
$347
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.