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 $128.82 Median $2,290.87 Typical High $6,606.93 | Facility | None | $128.82 | $2,290.87 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $218.78 | Professional | None | $87.10 | $128.82 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $74.13 | Professional | None | $56.23 | $74.13 | $74.13 |
BCBS 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 Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $234.42 | Professional | None | $107.15 | $154.88 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $239.88 Typical High $1,659.59 | Facility | None | $120.23 | $239.88 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $223.87 | Professional | None | $91.20 | $131.83 | $223.87 |
Lucent Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,148.15 | $1,380.38 |
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 $104.71 Median $151.36 Typical High $257.04 | Professional | None | $104.71 | $151.36 | $257.04 |
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 $42.66 Median $63.10 Typical High $85.11 | Professional | 52 · Reduced service | $42.66 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $25.12 Typical High $33.88 | Professional | 53 · Discontinued | $16.98 | $25.12 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $93.33 Typical High $128.82 | Professional | 54 · Surgery only | $63.10 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $18.62 Typical High $25.70 | Professional | 55 · Aftercare only | $12.59 | $18.62 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.59 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.51 | $12.59 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $87.10 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $58.88 | $87.10 | $120.23 |
Where Tennessee sits
The same service costs 3.5 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· 17th of 51
$191
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.