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 $109.65 Median $141.25 Typical High $208.93 | Professional | None | $109.65 | $141.25 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $831.76 Typical High $1,995.26 | Facility | None | $407.38 | $831.76 | $1,995.26 |
BCBS Tennessee Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $223.87 | Professional | None | $123.03 | $158.49 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $114.82 Typical High $213.80 | Facility | None | $50.12 | $114.82 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $208.93 | Professional | None | $97.72 | $120.23 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,230.27 | Professional | None | $1,202.26 | $1,202.26 | $1,230.27 |
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 $112.20 Median $144.54 Typical High $245.47 | Professional | None | $112.20 | $144.54 | $245.47 |
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 $54.95 Median $70.79 Typical High $104.71 | Professional | 52 · Reduced service | $54.95 | $70.79 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.18 Typical High $41.69 | Professional | 53 · Discontinued | $21.88 | $28.18 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $104.71 Typical High $158.49 | Professional | 54 · Surgery only | $83.18 | $104.71 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.89 Typical High $31.62 | Professional | 55 · Aftercare only | $16.60 | $20.89 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.13 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.96 | $14.13 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $97.72 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $77.62 | $97.72 | $147.91 |
Where Tennessee sits
The same service costs 4.1 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
$182
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.