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 $602.56 Median $2,290.87 Typical High $7,585.78 | Facility | None | $602.56 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $251.19 Typical High $407.38 | Professional | None | $107.15 | $251.19 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $309.03 | Professional | None | $257.04 | $309.03 | $309.03 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $389.05 | Professional | None | $120.23 | $223.87 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $380.19 Typical High $1,659.59 | Facility | None | $194.98 | $380.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $204.17 Typical High $363.08 | Professional | None | $95.50 | $204.17 | $363.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,398.83 | Professional | None | $2,041.74 | $2,041.74 | $2,398.83 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $109.65 Median $239.88 Typical High $416.87 | Professional | None | $109.65 | $239.88 | $416.87 |
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 $53.70 Median $120.23 Typical High $204.17 | Professional | 52 · Reduced service | $53.70 | $120.23 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $47.86 Typical High $81.28 | Professional | 53 · Discontinued | $21.38 | $47.86 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $181.97 Typical High $309.03 | Professional | 54 · Surgery only | $81.28 | $181.97 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $36.31 Typical High $61.66 | Professional | 55 · Aftercare only | $16.22 | $36.31 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $23.99 Typical High $40.74 | Professional | 56 · Pre-op care only | $10.72 | $23.99 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $169.82 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $75.86 | $169.82 | $288.40 |
Where Tennessee sits
The same service costs 4.2 times more in Wisconsin than in Kentucky. 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· 13th of 51
$302
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.