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 $1,071.52 Median $1,096.48 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,096.48 | $1,548.82 |
BCBS Tennessee Setting Facility Modifier None Typical Low $831.76 Median $1,621.81 Typical High $3,467.37 | Facility | None | $831.76 | $1,621.81 | $3,467.37 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,000.00 | $1,288.25 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,174.90 Typical High $2,691.53 | Facility | None | $588.84 | $1,174.90 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,348.96 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,715.19 | Professional | None | $10,000.00 | $10,000.00 | $10,715.19 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $2,344.23 | Professional | None | $812.83 | $1,174.90 | $2,344.23 |
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 $524.81 Median $537.03 Typical High $741.31 | Professional | 52 · Reduced service | $524.81 | $537.03 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $295.12 | Professional | 53 · Discontinued | $213.80 | $218.78 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $1,122.02 | Professional | 54 · Surgery only | $794.33 | $812.83 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $223.87 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $1,047.13 |
Where Tennessee sits
The same service costs 5.8 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· 24th of 51
$1,413
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.