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 $138.04 Median $223.87 Typical High $338.84 | Professional | None | $138.04 | $223.87 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
BCBS Tennessee Setting Facility Modifier None Typical Low $831.76 Median $1,584.89 Typical High $3,467.37 | Facility | None | $831.76 | $1,584.89 | $3,467.37 |
BCBS Tennessee Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $338.84 | Professional | None | $154.88 | $229.09 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $380.19 Typical High $1,659.59 | Facility | None | $199.53 | $380.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $323.59 | Professional | None | $123.03 | $194.98 | $323.59 |
Lucent Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,041.74 | $2,398.83 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $371.54 | Professional | None | $141.25 | $218.78 | $371.54 |
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 $69.18 Median $112.20 Typical High $165.96 | Professional | 52 · Reduced service | $69.18 | $112.20 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $44.67 Typical High $67.61 | Professional | 53 · Discontinued | $27.54 | $44.67 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $165.96 Typical High $251.19 | Professional | 54 · Surgery only | $102.33 | $165.96 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $33.88 Typical High $50.12 | Professional | 55 · Aftercare only | $20.89 | $33.88 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $22.39 Typical High $33.88 | Professional | 56 · Pre-op care only | $13.80 | $22.39 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $154.88 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $95.50 | $154.88 | $234.42 |
Where Tennessee sits
The same service costs 4.2 times more in Wyoming 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· 12th 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.