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 $42.66 Median $58.88 Typical High $95.50 | Professional | None | $42.66 | $58.88 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $85.11 | Professional | None | $56.23 | $74.13 | $85.11 |
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 $52.48 Median $70.79 Typical High $102.33 | Professional | None | $52.48 | $70.79 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $102.33 | Professional | None | $45.71 | $58.88 | $102.33 |
Lucent Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | None | $501.19 | $501.19 | $575.44 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $112.20 | Professional | None | $51.29 | $66.07 | $112.20 |
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 $20.89 Median $26.30 Typical High $34.67 | Professional | 52 · Reduced service | $20.89 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.72 Typical High $13.80 | Professional | 53 · Discontinued | $8.32 | $10.72 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $39.81 Typical High $52.48 | Professional | 54 · Surgery only | $30.90 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.94 Typical High $10.47 | Professional | 55 · Aftercare only | $6.31 | $7.94 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.25 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.17 | $5.25 | $6.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.84 Median $37.15 Typical High $48.98 | Professional | 78 · Unplanned return to OR | $28.84 | $37.15 | $48.98 |
Where Tennessee sits
The same service costs 4.2 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· 21st of 51
$81.28
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.