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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,905.46 | $1,949.84 | $2,818.38 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,548.82 Typical High $3,890.45 | Facility | None | $501.19 | $1,548.82 | $3,890.45 |
BCBS Tennessee Setting Professional Modifier None Typical Low $2,089.30 Median $2,754.23 Typical High $4,570.88 | Professional | None | $2,089.30 | $2,754.23 | $4,570.88 |
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 $1,905.46 Median $2,454.71 Typical High $3,981.07 | Professional | None | $1,905.46 | $2,454.71 | $3,981.07 |
Lucent Health Setting Professional Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $18,620.87 | Professional | None | $15,135.61 | $15,135.61 | $18,620.87 |
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 $1,949.84 Median $2,691.53 Typical High $4,570.88 | Professional | None | $1,949.84 | $2,691.53 | $4,570.88 |
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 $954.99 Median $977.24 Typical High $1,380.38 | Professional | 52 · Reduced service | $954.99 | $977.24 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $389.05 Typical High $562.34 | Professional | 53 · Discontinued | $380.19 | $389.05 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $416.87 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $194.98 Typical High $281.84 | Professional | 56 · Pre-op care only | $190.55 | $194.98 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,949.84 |
Where Tennessee sits
The same service costs 8.1 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· 35th of 51
$2,455
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.