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 $54.95 Median $79.43 Typical High $117.49 | Professional | None | $54.95 | $79.43 | $117.49 |
BCBS 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 Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $144.54 | Professional | None | $69.18 | $97.72 | $144.54 |
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 $58.88 Median $83.18 Typical High $141.25 | Professional | None | $58.88 | $83.18 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $831.76 | Professional | None | $724.44 | $724.44 | $831.76 |
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 $66.07 Median $91.20 Typical High $154.88 | Professional | None | $66.07 | $91.20 | $154.88 |
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 $27.54 Median $38.02 Typical High $52.48 | Professional | 52 · Reduced service | $27.54 | $38.02 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $15.49 Typical High $20.89 | Professional | 53 · Discontinued | $10.96 | $15.49 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $57.54 Typical High $77.62 | Professional | 54 · Surgery only | $40.74 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $11.48 Typical High $15.85 | Professional | 55 · Aftercare only | $8.13 | $11.48 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.76 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.50 | $7.76 | $10.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.02 Median $53.70 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $38.02 | $53.70 | $72.44 |
Where Tennessee sits
The same service costs 3.8 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
$117
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.