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 $724.44 Median $758.58 Typical High $1,348.96 | Professional | None | $724.44 | $758.58 | $1,348.96 |
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 $812.83 Median $1,096.48 Typical High $1,862.09 | Professional | None | $812.83 | $1,096.48 | $1,862.09 |
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 $707.95 Median $870.96 Typical High $1,513.56 | Professional | None | $707.95 | $870.96 | $1,513.56 |
Lucent Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,456.54 | Professional | None | $6,025.60 | $6,025.60 | $6,456.54 |
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 $741.31 Median $1,023.29 Typical High $1,819.70 | Professional | None | $741.31 | $1,023.29 | $1,819.70 |
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 $363.08 Median $380.19 Typical High $575.44 | Professional | 52 · Reduced service | $363.08 | $380.19 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $229.09 | Professional | 53 · Discontinued | $144.54 | $151.36 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $575.44 Typical High $851.14 | Professional | 54 · Surgery only | $549.54 | $575.44 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $114.82 Typical High $173.78 | Professional | 55 · Aftercare only | $109.65 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $75.86 Typical High $114.82 | Professional | 56 · Pre-op care only | $72.44 | $75.86 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $537.03 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $512.86 | $537.03 | $794.33 |
Where Tennessee sits
The same service costs 7.4 times more in Oklahoma 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· 6th of 51
$2,042
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.