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 $2,630.27 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,630.27 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $2,818.38 Median $2,884.03 Typical High $4,168.69 | Professional | None | $2,818.38 | $2,884.03 | $4,168.69 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $3,162.28 Median $4,265.80 Typical High $7,413.10 | Professional | None | $3,162.28 | $4,265.80 | $7,413.10 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $3,630.78 Typical High $5,888.44 | Professional | None | $2,818.38 | $3,630.78 | $5,888.44 |
Lucent Health Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $27,542.29 | Professional | None | $22,387.21 | $22,387.21 | $27,542.29 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $2,884.03 Median $4,168.69 Typical High $6,760.83 | Professional | None | $2,884.03 | $4,168.69 | $6,760.83 |
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 $1,412.54 Median $1,445.44 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,412.54 | $1,445.44 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $575.44 Typical High $831.76 | Professional | 53 · Discontinued | $562.34 | $575.44 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,137.96 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,137.96 | $2,137.96 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $436.52 Typical High $616.60 | Professional | 55 · Aftercare only | $426.58 | $436.52 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $288.40 Typical High $416.87 | Professional | 56 · Pre-op care only | $281.84 | $288.40 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $2,884.03 |
Ambetter Setting Professional Modifier AS · PA/NP assist Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | AS · PA/NP assist | $645.65 | $645.65 | $645.65 |
Where Tennessee sits
The same service costs 18.2 times more in Alaska than in Texas. 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· 36th of 51
$3,311
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.