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 $977.24 Median $1,023.29 Typical High $1,621.81 | Professional | None | $977.24 | $1,023.29 | $1,621.81 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,862.09 Median $3,981.07 Typical High $8,511.38 | Facility | None | $1,862.09 | $3,981.07 | $8,511.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,630.27 | Professional | None | $1,122.02 | $1,548.82 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,311.31 Typical High $6,918.31 | Facility | None | $588.84 | $3,311.31 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $2,089.30 | Professional | None | $912.01 | $1,348.96 | $2,089.30 |
Lucent Health Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $8,128.31 | Professional | None | $7,079.46 | $7,079.46 | $8,128.31 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,584.89 | $2,398.83 |
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 $489.78 Median $512.86 Typical High $812.83 | Professional | 52 · Reduced service | $489.78 | $512.86 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $323.59 | Professional | 53 · Discontinued | $194.98 | $204.17 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $776.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $724.44 | $776.25 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $239.88 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $162.18 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $724.44 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $676.08 | $724.44 | $1,122.02 |
Where Tennessee sits
The same service costs 5.1 times more in Wisconsin 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· 4th of 51
$2,951
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.