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 $812.83 Median $2,398.83 Typical High $7,585.78 | Facility | None | $812.83 | $2,398.83 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $331.13 | Professional | None | $177.83 | $234.42 | $331.13 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $389.05 | Professional | None | $213.80 | $281.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $645.65 Typical High $2,187.76 | Facility | None | $512.86 | $645.65 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $389.05 | Professional | None | $177.83 | $239.88 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,398.83 | Professional | None | $1,862.09 | $1,862.09 | $2,398.83 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $436.52 | Professional | None | $169.82 | $239.88 | $436.52 |
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 $89.13 Median $117.49 Typical High $165.96 | Professional | 52 · Reduced service | $89.13 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $46.77 Typical High $66.07 | Professional | 53 · Discontinued | $35.48 | $46.77 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $177.83 Typical High $251.19 | Professional | 54 · Surgery only | $134.90 | $177.83 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $35.48 Typical High $50.12 | Professional | 55 · Aftercare only | $26.92 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $23.44 Typical High $33.11 | Professional | 56 · Pre-op care only | $17.78 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $165.96 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $125.89 | $165.96 | $234.42 |
Where Tennessee sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 26th of 51
$295
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.