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 $128.82 Median $257.04 Typical High $389.05 | Professional | None | $128.82 | $257.04 | $389.05 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $389.05 | Professional | None | $144.54 | $251.19 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $707.95 Typical High $2,187.76 | Facility | None | $524.81 | $707.95 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $331.13 | Professional | None | $114.82 | $194.98 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,951.21 | $2,951.21 |
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 $128.82 Median $245.47 Typical High $426.58 | Professional | None | $128.82 | $245.47 | $426.58 |
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 $64.57 Median $128.82 Typical High $194.98 | Professional | 52 · Reduced service | $64.57 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $52.48 Typical High $77.62 | Professional | 53 · Discontinued | $25.70 | $52.48 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $194.98 Typical High $295.12 | Professional | 54 · Surgery only | $95.50 | $194.98 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $38.90 Typical High $58.88 | Professional | 55 · Aftercare only | $19.05 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $25.70 Typical High $38.90 | Professional | 56 · Pre-op care only | $12.88 | $25.70 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $181.97 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $89.13 | $181.97 | $275.42 |
Where Tennessee sits
The same service costs 4.7 times more in Alaska than in Virginia. 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· 10th of 51
$380
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.