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 $2,630.27 Median $3,235.94 Typical High $7,585.78 | Facility | None | $2,630.27 | $3,235.94 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $3,090.30 Median $3,235.94 Typical High $4,897.79 | Professional | None | $3,090.30 | $3,235.94 | $4,897.79 |
BCBS Tennessee Setting Professional Modifier None Typical Low $3,548.13 Median $4,786.30 Typical High $8,317.64 | Professional | None | $3,548.13 | $4,786.30 | $8,317.64 |
Lucent Health Setting Professional Modifier None Typical Low $28,840.32 Median $67,608.30 Typical High $67,608.30 | Professional | None | $28,840.32 | $67,608.30 | $67,608.30 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $3,311.31 Median $4,677.35 Typical High $7,585.78 | Professional | None | $3,311.31 | $4,677.35 | $7,585.78 |
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 $1,548.82 Median $1,621.81 Typical High $2,454.71 | Professional | 52 · Reduced service | $1,548.82 | $1,621.81 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $645.65 Typical High $977.24 | Professional | 53 · Discontinued | $616.60 | $645.65 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,398.83 Typical High $3,630.78 | Professional | 54 · Surgery only | $2,344.23 | $2,398.83 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $478.63 Typical High $724.44 | Professional | 55 · Aftercare only | $467.74 | $478.63 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $323.59 Typical High $489.78 | Professional | 56 · Pre-op care only | $309.03 | $323.59 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,238.72 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,238.72 | $3,388.44 |
Where Tennessee sits
The same service costs 23.4 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
$4,266
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.