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 $151.36 Typical High $234.42 | Professional | None | $107.15 | $151.36 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $398.11 | Professional | None | $131.83 | $208.93 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $162.18 Typical High $302.00 | Facility | None | $50.12 | $162.18 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $331.13 | Professional | None | $114.82 | $169.82 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,318.26 | $1,659.59 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $371.54 | Professional | None | $114.82 | $194.98 | $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 $48.98 Median $75.86 Typical High $114.82 | Professional | 52 · Reduced service | $48.98 | $75.86 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $30.20 Typical High $45.71 | Professional | 53 · Discontinued | $19.50 | $30.20 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $114.82 Typical High $173.78 | Professional | 54 · Surgery only | $74.13 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $22.91 Typical High $34.67 | Professional | 55 · Aftercare only | $14.79 | $22.91 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $15.14 Typical High $22.91 | Professional | 56 · Pre-op care only | $9.77 | $15.14 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $107.15 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $69.18 | $107.15 | $162.18 |
Where Tennessee sits
The same service costs 4.1 times more in Alaska 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· 12th of 51
$245
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.