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 $3,981.07 Typical High $7,585.78 | Facility | None | $2,630.27 | $3,981.07 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $4,073.80 Typical High $6,165.95 | Professional | None | $3,981.07 | $4,073.80 | $6,165.95 |
BCBS Tennessee Setting Professional Modifier None Typical Low $4,365.16 Median $6,165.95 Typical High $10,715.19 | Professional | None | $4,365.16 | $6,165.95 | $10,715.19 |
Lucent Health Setting Professional Modifier None Typical Low $37,153.52 Median $87,096.36 Typical High $87,096.36 | Professional | None | $37,153.52 | $87,096.36 | $87,096.36 |
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 $3,801.89 Median $6,025.60 Typical High $9,772.37 | Professional | None | $3,801.89 | $6,025.60 | $9,772.37 |
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 $1,995.26 Median $2,041.74 Typical High $3,090.30 | Professional | 52 · Reduced service | $1,995.26 | $2,041.74 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $831.76 Typical High $1,230.27 | Professional | 53 · Discontinued | $794.33 | $831.76 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $3,090.30 Typical High $4,677.35 | Professional | 54 · Surgery only | $2,951.21 | $3,090.30 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $616.60 Typical High $933.25 | Professional | 55 · Aftercare only | $588.84 | $616.60 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $407.38 Typical High $616.60 | Professional | 56 · Pre-op care only | $398.11 | $407.38 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $2,884.03 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $2,754.23 | $2,884.03 | $4,365.16 |
Where Tennessee sits
The same service costs 24.0 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
$5,370
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.