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 $1,174.90 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,288.25 | $1,698.24 |
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 $1,318.26 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,737.80 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $11,481.54 | Facility | None | $602.56 | $5,370.32 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,513.56 | $2,089.30 |
Lucent Health Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $10,000.00 | Professional | None | $9,120.11 | $9,120.11 | $10,000.00 |
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 $1,023.29 Median $1,380.38 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,380.38 | $2,570.40 |
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 $588.84 Median $602.56 Typical High $812.83 | Professional | 52 · Reduced service | $588.84 | $602.56 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $331.13 | Professional | 53 · Discontinued | $234.42 | $239.88 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $891.25 Typical High $1,230.27 | Professional | 54 · Surgery only | $870.96 | $891.25 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $177.83 Typical High $245.47 | Professional | 55 · Aftercare only | $173.78 | $177.83 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $165.96 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $831.76 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $812.83 | $831.76 | $1,148.15 |
Where Tennessee sits
The same service costs 7.4 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· 20th of 51
$1,905
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.