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 $288.40 Median $331.13 Typical High $501.19 | Professional | None | $288.40 | $331.13 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $363.08 | Professional | None | $239.88 | $288.40 | $363.08 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $524.81 | Professional | None | $302.00 | $371.54 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $537.03 Typical High $2,187.76 | Facility | None | $338.84 | $537.03 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $467.74 | Professional | None | $245.47 | $275.42 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,884.03 | Professional | None | $2,398.83 | $2,398.83 | $2,884.03 |
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 $275.42 Median $338.84 Typical High $575.44 | Professional | None | $275.42 | $338.84 | $575.44 |
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 $144.54 Median $154.88 Typical High $234.42 | Professional | 52 · Reduced service | $144.54 | $154.88 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $63.10 Typical High $93.33 | Professional | 53 · Discontinued | $57.54 | $63.10 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $234.42 Typical High $331.13 | Professional | 54 · Surgery only | $204.17 | $234.42 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $46.77 Typical High $70.79 | Professional | 55 · Aftercare only | $43.65 | $46.77 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.90 Typical High $46.77 | Professional | 56 · Pre-op care only | $28.84 | $30.90 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $218.78 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $204.17 | $218.78 | $331.13 |
Where Tennessee sits
The same service costs 5.8 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· 20th of 51
$427
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.