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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,096.48 | $1,479.11 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,137.96 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,513.56 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,025.60 | Facility | None | $741.31 | $3,235.94 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,000.00 | $1,318.26 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $8,128.31 | Professional | None | $7,943.28 | $7,943.28 | $8,128.31 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $2,290.87 | Professional | None | $891.25 | $1,202.26 | $2,290.87 |
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 $512.86 Median $512.86 Typical High $707.95 | Professional | 52 · Reduced service | $512.86 | $512.86 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $208.93 Typical High $288.40 | Professional | 53 · Discontinued | $204.17 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $776.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $758.58 | $776.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $154.88 Typical High $213.80 | Professional | 55 · Aftercare only | $151.36 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $104.71 Typical High $141.25 | Professional | 56 · Pre-op care only | $102.33 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $724.44 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $707.95 | $724.44 | $1,000.00 |
Where Tennessee sits
The same service costs 6.3 times more in Alaska than in Utah. 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· 20th of 51
$1,660
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.