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 $229.09 Median $281.84 Typical High $426.58 | Professional | None | $229.09 | $281.84 | $426.58 |
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 $269.15 Median $398.11 Typical High $676.08 | Professional | None | $269.15 | $398.11 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $162.18 Typical High $302.00 | Facility | None | $50.12 | $162.18 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $467.74 | Professional | None | $245.47 | $316.23 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,884.03 | Professional | None | $2,187.76 | $2,187.76 | $2,884.03 |
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 $213.80 Median $281.84 Typical High $549.54 | Professional | None | $213.80 | $281.84 | $549.54 |
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 $114.82 Median $131.83 Typical High $181.97 | Professional | 52 · Reduced service | $114.82 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $53.70 Typical High $72.44 | Professional | 53 · Discontinued | $45.71 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $199.53 Typical High $275.42 | Professional | 54 · Surgery only | $173.78 | $199.53 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $39.81 Typical High $54.95 | Professional | 55 · Aftercare only | $34.67 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $186.21 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $162.18 | $186.21 | $257.04 |
Where Tennessee sits
The same service costs 5.4 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· 24th of 51
$355
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.