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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $630.96 | Professional | None | $363.08 | $436.52 | $630.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $870.96 Median $1,621.81 Typical High $3,467.37 | Facility | None | $870.96 | $1,621.81 | $3,467.37 |
BCBS Tennessee Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $707.95 | Professional | None | $407.38 | $501.19 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,479.11 Typical High $2,691.53 | Facility | None | $524.81 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $630.96 | Professional | None | $323.59 | $371.54 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,890.45 | Professional | None | $3,235.94 | $3,235.94 | $3,890.45 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $758.58 | Professional | None | $363.08 | $467.74 | $758.58 |
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 $181.97 Median $213.80 Typical High $316.23 | Professional | 52 · Reduced service | $181.97 | $213.80 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $85.11 Typical High $125.89 | Professional | 53 · Discontinued | $72.44 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $316.23 Typical High $478.63 | Professional | 54 · Surgery only | $275.42 | $316.23 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $63.10 Typical High $95.50 | Professional | 55 · Aftercare only | $54.95 | $63.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $42.66 Typical High $63.10 | Professional | 56 · Pre-op care only | $36.31 | $42.66 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $295.12 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $257.04 | $295.12 | $446.68 |
Where Tennessee sits
The same service costs 6.0 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· 18th of 51
$603
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.