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 $1,380.38 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,380.38 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $575.44 | Professional | None | $363.08 | $478.63 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,137.96 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $977.24 | Professional | None | $436.52 | $575.44 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,089.30 Typical High $3,801.89 | Facility | None | $588.84 | $2,089.30 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $870.96 | Professional | None | $398.11 | $478.63 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
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 $380.19 Median $549.54 Typical High $891.25 | Professional | None | $380.19 | $549.54 | $891.25 |
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 $181.97 Median $239.88 Typical High $281.84 | Professional | 52 · Reduced service | $181.97 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $95.50 Typical High $112.20 | Professional | 53 · Discontinued | $72.44 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $354.81 Typical High $416.87 | Professional | 54 · Surgery only | $269.15 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $72.44 Typical High $85.11 | Professional | 55 · Aftercare only | $53.70 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $47.86 Typical High $56.23 | Professional | 56 · Pre-op care only | $36.31 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $331.13 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $251.19 | $331.13 | $389.05 |
Where Tennessee sits
The same service costs 10.2 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· 6th of 51
$1,122
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.