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 $1,258.93 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,380.38 | $1,862.09 |
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 $1,412.54 Median $1,949.84 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,949.84 | $2,511.89 |
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 $1,258.93 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,621.81 | $2,290.87 |
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 $1,122.02 Median $1,513.56 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,513.56 | $2,754.23 |
7 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 $630.96 Median $645.65 Typical High $891.25 | Professional | 52 · Reduced service | $630.96 | $645.65 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $354.81 | Professional | 53 · Discontinued | $251.19 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $977.24 Typical High $1,318.26 | Professional | 54 · Surgery only | $954.99 | $977.24 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $194.98 Typical High $269.15 | Professional | 55 · Aftercare only | $190.55 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $128.82 Typical High $177.83 | Professional | 56 · Pre-op care only | $125.89 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $912.01 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $891.25 | $912.01 | $1,230.27 |
Ambetter Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 62 · Two surgeons | $1,258.93 | $1,258.93 | $1,258.93 |
Where Tennessee sits
The same service costs 7.2 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· 22nd of 51
$1,995
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.