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 $147.91 Median $269.15 Typical High $407.38 | Professional | None | $147.91 | $269.15 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $63.10 | Professional | None | $58.88 | $58.88 | $63.10 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $416.87 | Professional | None | $165.96 | $263.03 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,659.59 | Facility | None | $229.09 | $398.11 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $389.05 | Professional | None | $128.82 | $223.87 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,398.83 | Professional | None | $2,290.87 | $2,290.87 | $2,398.83 |
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 $151.36 Median $263.03 Typical High $426.58 | Professional | None | $151.36 | $263.03 | $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 $74.13 Median $134.90 Typical High $204.17 | Professional | 52 · Reduced service | $74.13 | $134.90 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $53.70 Typical High $81.28 | Professional | 53 · Discontinued | $29.51 | $53.70 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $204.17 Typical High $302.00 | Professional | 54 · Surgery only | $109.65 | $204.17 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $40.74 Typical High $60.26 | Professional | 55 · Aftercare only | $21.88 | $40.74 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $26.92 Typical High $40.74 | Professional | 56 · Pre-op care only | $14.79 | $26.92 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $190.55 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $102.33 | $190.55 | $281.84 |
Where Tennessee sits
The same service costs 3.8 times more in Wyoming 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· 11th of 51
$355
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.