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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $263.03 | Professional | None | $112.20 | $169.82 | $263.03 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $2,884.03 | Facility | None | $575.44 | $1,380.38 | $2,884.03 |
BCBS Tennessee Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $446.68 | Professional | None | $141.25 | $229.09 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $363.08 Typical High $2,691.53 | Facility | None | $186.21 | $363.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $380.19 | Professional | None | $120.23 | $190.55 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,479.11 | $1,819.70 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $398.11 | Professional | None | $123.03 | $208.93 | $398.11 |
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 $51.29 Median $85.11 Typical High $128.82 | Professional | 52 · Reduced service | $51.29 | $85.11 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $33.88 Typical High $51.29 | Professional | 53 · Discontinued | $20.42 | $33.88 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $125.89 Typical High $190.55 | Professional | 54 · Surgery only | $77.62 | $125.89 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $25.12 Typical High $38.02 | Professional | 55 · Aftercare only | $15.49 | $25.12 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $16.98 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.23 | $16.98 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $117.49 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $72.44 | $117.49 | $177.83 |
Where Tennessee sits
The same service costs 3.9 times more in Oklahoma 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
$295
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.