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 $1,548.82 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,621.81 | $2,570.40 |
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 $1,778.28 Median $2,454.71 Typical High $4,168.69 | Professional | None | $1,778.28 | $2,454.71 | $4,168.69 |
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 $1,445.44 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,445.44 | $2,137.96 | $3,235.94 |
Lucent Health Setting Professional Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $12,882.50 | Professional | None | $11,220.18 | $11,220.18 | $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 $1,584.89 Median $2,511.89 Typical High $3,801.89 | Professional | None | $1,584.89 | $2,511.89 | $3,801.89 |
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 $776.25 Median $812.83 Typical High $1,288.25 | Professional | 52 · Reduced service | $776.25 | $812.83 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $331.13 Typical High $512.86 | Professional | 53 · Discontinued | $309.03 | $331.13 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,230.27 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,174.90 | $1,230.27 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $245.47 Typical High $389.05 | Professional | 55 · Aftercare only | $234.42 | $245.47 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $257.04 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,148.15 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,148.15 | $1,819.70 |
Where Tennessee sits
The same service costs 5.8 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· 31st of 51
$2,239
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.