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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $208.93 | Professional | None | $109.65 | $141.25 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $257.04 | Professional | None | $131.83 | $141.25 | $257.04 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $229.09 | Professional | None | $131.83 | $177.83 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $95.50 Typical High $602.56 | Facility | None | $52.48 | $95.50 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $239.88 | Professional | None | $109.65 | $151.36 | $239.88 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,380.38 | $1,380.38 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $281.84 | Professional | None | $112.20 | $154.88 | $281.84 |
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 $54.95 Median $70.79 Typical High $97.72 | Professional | 52 · Reduced service | $54.95 | $70.79 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.18 Typical High $38.90 | Professional | 53 · Discontinued | $21.88 | $28.18 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $104.71 Typical High $144.54 | Professional | 54 · Surgery only | $83.18 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.89 Typical High $28.84 | Professional | 55 · Aftercare only | $16.60 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.13 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.96 | $14.13 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $97.72 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $77.62 | $97.72 | $134.90 |
Where Tennessee sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 29th of 51
$178
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.