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 $4,168.69 Median $4,365.16 Typical High $6,606.93 | Professional | None | $4,168.69 | $4,365.16 | $6,606.93 |
BCBS Setting Professional Modifier None Typical Low $4,677.35 Median $6,606.93 Typical High $11,220.18 | Professional | None | $4,677.35 | $6,606.93 | $11,220.18 |
Lucent Health Setting Professional Modifier None Typical Low $38,904.51 Median $162,181.01 Typical High $162,181.01 | Professional | None | $38,904.51 | $162,181.01 | $162,181.01 |
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 $4,073.80 Median $6,309.57 Typical High $10,471.29 | Professional | None | $4,073.80 | $6,309.57 | $10,471.29 |
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 $2,089.30 Median $2,187.76 Typical High $3,311.31 | Professional | 52 · Reduced service | $2,089.30 | $2,187.76 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $870.96 Typical High $1,318.26 | Professional | 53 · Discontinued | $831.76 | $870.96 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,311.31 Typical High $4,897.79 | Professional | 54 · Surgery only | $3,162.28 | $3,311.31 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $660.69 Typical High $1,000.00 | Professional | 55 · Aftercare only | $630.96 | $660.69 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $436.52 Typical High $660.69 | Professional | 56 · Pre-op care only | $416.87 | $436.52 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $3,090.30 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $2,951.21 | $3,090.30 | $4,570.88 |
Where Tennessee sits
The same service costs 22.9 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· 25th of 51
$5,623
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.