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 $1,380.38 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,380.38 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $426.58 | Professional | None | $162.18 | $295.12 | $426.58 |
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 $208.93 Median $407.38 Typical High $776.25 | Professional | None | $208.93 | $407.38 | $776.25 |
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 $169.82 Median $302.00 Typical High $524.81 | Professional | None | $169.82 | $302.00 | $524.81 |
Lucent Health Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,754.23 | $3,235.94 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $169.82 Median $316.23 Typical High $588.84 | Professional | None | $169.82 | $316.23 | $588.84 |
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 $81.28 Median $147.91 Typical High $213.80 | Professional | 52 · Reduced service | $81.28 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $58.88 Typical High $85.11 | Professional | 53 · Discontinued | $32.36 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $223.87 Typical High $323.59 | Professional | 54 · Surgery only | $123.03 | $223.87 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $44.67 Typical High $64.57 | Professional | 55 · Aftercare only | $24.55 | $44.67 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $29.51 Typical High $42.66 | Professional | 56 · Pre-op care only | $16.22 | $29.51 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $208.93 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $114.82 | $208.93 | $302.00 |
Where Tennessee sits
The same service costs 5.1 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· 14th of 51
$427
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.