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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $870.96 | Professional | None | $426.58 | $562.34 | $870.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,412.54 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,412.54 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $1,412.54 | Professional | None | $549.54 | $758.58 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,311.31 Typical High $6,606.93 | Facility | None | $741.31 | $3,311.31 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $1,096.48 | Professional | None | $426.58 | $616.60 | $1,096.48 |
Lucent Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $5,370.32 | Professional | None | $4,466.84 | $4,466.84 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $1,288.25 | Professional | None | $467.74 | $741.31 | $1,288.25 |
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 $204.17 Median $281.84 Typical High $380.19 | Professional | 52 · Reduced service | $204.17 | $281.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $112.20 Typical High $151.36 | Professional | 53 · Discontinued | $83.18 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $426.58 Typical High $562.34 | Professional | 54 · Surgery only | $309.03 | $426.58 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $85.11 Typical High $112.20 | Professional | 55 · Aftercare only | $61.66 | $85.11 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $56.23 Typical High $75.86 | Professional | 56 · Pre-op care only | $40.74 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $398.11 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $288.40 | $398.11 | $524.81 |
Where Tennessee sits
The same service costs 5.0 times more in Alaska 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· 13th of 51
$977
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.