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 $234.42 Median $295.12 Typical High $436.52 | Professional | None | $234.42 | $295.12 | $436.52 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $851.14 Typical High $2,089.30 | Facility | None | $407.38 | $851.14 | $2,089.30 |
BCBS Tennessee Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $478.63 | Professional | None | $263.03 | $338.84 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $1,659.59 | Facility | None | $208.93 | $389.05 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $436.52 | Professional | None | $204.17 | $257.04 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $512.86 | Professional | None | $239.88 | $316.23 | $512.86 |
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 $117.49 Median $144.54 Typical High $218.78 | Professional | 52 · Reduced service | $117.49 | $144.54 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $57.54 Typical High $87.10 | Professional | 53 · Discontinued | $46.77 | $57.54 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $218.78 Typical High $323.59 | Professional | 54 · Surgery only | $173.78 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $43.65 Typical High $64.57 | Professional | 55 · Aftercare only | $34.67 | $43.65 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $28.84 Typical High $43.65 | Professional | 56 · Pre-op care only | $23.44 | $28.84 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $204.17 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $162.18 | $204.17 | $302.00 |
Where Tennessee sits
The same service costs 5.2 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· 24th of 51
$372
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.