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 $1,621.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,621.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,445.44 | $1,949.84 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,318.26 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,479.11 | $1,949.84 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $9,120.11 | Facility | None | $602.56 | $4,265.80 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,698.24 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Professional | None | $11,220.18 | $11,220.18 | $11,220.18 |
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 $1,148.15 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,584.89 | $2,884.03 |
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 $660.69 Median $676.08 Typical High $933.25 | Professional | 52 · Reduced service | $660.69 | $676.08 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $269.15 Typical High $371.54 | Professional | 53 · Discontinued | $263.03 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,380.38 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $275.42 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $134.90 Typical High $186.21 | Professional | 56 · Pre-op care only | $131.83 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,288.25 |
Where Tennessee sits
The same service costs 24.5 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· 23rd of 51
$2,042
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.