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 $1,479.11 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,479.11 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $478.63 | Professional | None | $288.40 | $380.19 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $3,630.78 | Facility | None | $501.19 | $1,318.26 | $3,630.78 |
BCBS Tennessee Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $758.58 | Professional | None | $354.81 | $467.74 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $2,691.53 | Facility | None | $512.86 | $707.95 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $691.83 | Professional | None | $309.03 | $371.54 | $691.83 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
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 $309.03 Median $446.68 Typical High $707.95 | Professional | None | $309.03 | $446.68 | $707.95 |
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 $141.25 Median $190.55 Typical High $223.87 | Professional | 52 · Reduced service | $141.25 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $75.86 Typical High $89.13 | Professional | 53 · Discontinued | $57.54 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $281.84 Typical High $331.13 | Professional | 54 · Surgery only | $213.80 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $56.23 Typical High $66.07 | Professional | 55 · Aftercare only | $42.66 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $38.02 Typical High $44.67 | Professional | 56 · Pre-op care only | $28.84 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $263.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $199.53 | $263.03 | $309.03 |
Where Tennessee sits
The same service costs 5.8 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· 8th of 51
$676
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.