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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,230.27 | $1,318.26 | $2,041.74 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,995.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,819.70 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,698.24 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $12,882.50 | Professional | None | $12,882.50 | $12,882.50 | $12,882.50 |
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 $1,230.27 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,230.27 | $1,862.09 | $2,951.21 |
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 $616.60 Median $660.69 Typical High $1,023.29 | Professional | 52 · Reduced service | $616.60 | $660.69 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $416.87 | Professional | 53 · Discontinued | $245.47 | $263.03 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $1,548.82 | Professional | 54 · Surgery only | $933.25 | $977.24 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $309.03 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $204.17 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $1,445.44 |
Where Tennessee sits
The same service costs 4.9 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· 22nd of 51
$1,862
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.