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 $4,073.80 Typical High $15,848.93 | Facility | None | $2,630.27 | $4,073.80 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,258.93 | Professional | None | $741.31 | $794.33 | $1,258.93 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,819.70 | Professional | None | $851.14 | $1,096.48 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $2,691.53 | Facility | None | $512.86 | $707.95 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,513.56 | Professional | None | $707.95 | $1,047.13 | $1,513.56 |
Lucent Health Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
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 $741.31 Median $1,148.15 Typical High $1,778.28 | Professional | None | $741.31 | $1,148.15 | $1,778.28 |
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 $371.54 Median $398.11 Typical High $616.60 | Professional | 52 · Reduced service | $371.54 | $398.11 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $251.19 | Professional | 53 · Discontinued | $151.36 | $158.49 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $933.25 | Professional | 54 · Surgery only | $562.34 | $588.84 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $186.21 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $125.89 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $549.54 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $524.81 | $549.54 | $870.96 |
Where Tennessee sits
The same service costs 4.6 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· 19th of 51
$1,230
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.