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 $125.89 Median $190.55 Typical High $295.12 | Professional | None | $125.89 | $190.55 | $295.12 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $489.78 | Professional | None | $158.49 | $251.19 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $208.93 Typical High $398.11 | Facility | None | $50.12 | $208.93 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $416.87 | Professional | None | $131.83 | $213.80 | $416.87 |
Lucent Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,659.59 | $1,995.26 |
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 $134.90 Median $234.42 Typical High $457.09 | Professional | None | $134.90 | $234.42 | $457.09 |
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 $57.54 Median $95.50 Typical High $144.54 | Professional | 52 · Reduced service | $57.54 | $95.50 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $38.02 Typical High $57.54 | Professional | 53 · Discontinued | $22.91 | $38.02 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $141.25 Typical High $213.80 | Professional | 54 · Surgery only | $85.11 | $141.25 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $28.18 Typical High $42.66 | Professional | 55 · Aftercare only | $16.98 | $28.18 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $19.05 Typical High $28.84 | Professional | 56 · Pre-op care only | $11.48 | $19.05 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $131.83 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $79.43 | $131.83 | $199.53 |
Where Tennessee sits
The same service costs 4.6 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· 13th 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.