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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $223.87 | Professional | None | $138.04 | $162.18 | $223.87 |
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 $144.54 Median $181.97 Typical High $251.19 | Professional | None | $144.54 | $181.97 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $208.93 Typical High $1,659.59 | Facility | None | $104.71 | $208.93 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $245.47 | Professional | None | $117.49 | $131.83 | $245.47 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,348.96 | $2,290.87 | $2,290.87 |
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 $138.04 Median $173.78 Typical High $295.12 | Professional | None | $138.04 | $173.78 | $295.12 |
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 $74.13 Typical High $109.65 | Professional | 52 · Reduced service | $69.18 | $74.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $29.51 Typical High $44.67 | Professional | 53 · Discontinued | $28.18 | $29.51 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $109.65 Typical High $165.96 | Professional | 54 · Surgery only | $104.71 | $109.65 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $22.39 Typical High $33.11 | Professional | 55 · Aftercare only | $20.89 | $22.39 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.79 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.80 | $14.79 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $102.33 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $97.72 | $102.33 | $154.88 |
Where Tennessee sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 19th of 51
$224
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.