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 $1,621.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,621.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $891.25 | Professional | None | $501.19 | $562.34 | $891.25 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $8,317.64 | Facility | None | $1,288.25 | $3,388.44 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,380.38 | Professional | None | $575.44 | $851.14 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,786.30 Typical High $10,232.93 | Facility | None | $602.56 | $4,786.30 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $954.99 | Professional | None | $537.03 | $676.08 | $954.99 |
Lucent Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,786.30 | Professional | None | $4,168.69 | $4,168.69 | $4,786.30 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,202.26 | Professional | None | $467.74 | $616.60 | $1,202.26 |
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 $251.19 Median $269.15 Typical High $363.08 | Professional | 52 · Reduced service | $251.19 | $269.15 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $144.54 | Professional | 53 · Discontinued | $102.33 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $549.54 | Professional | 54 · Surgery only | $380.19 | $407.38 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $81.28 Typical High $109.65 | Professional | 55 · Aftercare only | $75.86 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $53.70 Typical High $72.44 | Professional | 56 · Pre-op care only | $50.12 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $380.19 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $354.81 | $380.19 | $512.86 |
Where Tennessee sits
The same service costs 7.8 times more in Alaska than in Texas. 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· 8th of 51
$1,148
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.