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 $1,479.11 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,479.11 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $912.01 | Professional | None | $575.44 | $602.56 | $912.01 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,122.02 Median $3,090.30 Typical High $8,317.64 | Facility | None | $1,122.02 | $3,090.30 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,479.11 | Professional | None | $630.96 | $851.14 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,090.30 Typical High $6,606.93 | Facility | None | $524.81 | $3,090.30 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,202.26 | Professional | None | $575.44 | $691.83 | $1,202.26 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,709.64 | Facility | None | $1,548.82 | $4,570.88 | $8,709.64 |
United Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,445.44 | Professional | None | $575.44 | $812.83 | $1,445.44 |
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 $288.40 Median $302.00 Typical High $457.09 | Professional | 52 · Reduced service | $288.40 | $302.00 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $120.23 Typical High $181.97 | Professional | 53 · Discontinued | $114.82 | $120.23 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $446.68 Typical High $676.08 | Professional | 54 · Surgery only | $426.58 | $446.68 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $89.13 Typical High $134.90 | Professional | 55 · Aftercare only | $87.10 | $89.13 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $60.26 Typical High $91.20 | Professional | 56 · Pre-op care only | $57.54 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $416.87 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $398.11 | $416.87 | $630.96 |
Where Tennessee sits
The same service costs 8.1 times more in Oklahoma than in Utah. 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
$1,514
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.