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 $107.15 Median $131.83 Typical High $186.21 | Professional | None | $107.15 | $131.83 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $204.17 | Professional | None | $117.49 | $141.25 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $107.15 Typical High $199.53 | Facility | None | $50.12 | $107.15 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $186.21 | Professional | None | $97.72 | $109.65 | $186.21 |
Lucent Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,737.80 | Facility | None | $107.15 | $436.52 | $1,737.80 |
United Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $218.78 | Professional | None | $107.15 | $134.90 | $218.78 |
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 $53.70 Median $61.66 Typical High $93.33 | Professional | 52 · Reduced service | $53.70 | $61.66 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $24.55 Typical High $37.15 | Professional | 53 · Discontinued | $21.88 | $24.55 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $93.33 Typical High $138.04 | Professional | 54 · Surgery only | $81.28 | $93.33 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.62 Typical High $28.18 | Professional | 55 · Aftercare only | $16.22 | $18.62 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.30 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.96 | $12.30 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $87.10 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $75.86 | $87.10 | $128.82 |
Where Tennessee sits
The same service costs 4.4 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· 27th of 51
$158
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.