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 $912.01 Median $977.24 Typical High $1,513.56 | Professional | None | $912.01 | $977.24 | $1,513.56 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,089.30 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,445.44 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,949.84 Typical High $3,548.13 | Facility | None | $588.84 | $1,949.84 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $1,949.84 | Professional | None | $851.14 | $1,288.25 | $1,949.84 |
Lucent Health Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $2,238.72 | Professional | None | $933.25 | $1,479.11 | $2,238.72 |
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 $457.09 Median $478.63 Typical High $758.58 | Professional | 52 · Reduced service | $457.09 | $478.63 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $302.00 | Professional | 53 · Discontinued | $181.97 | $194.98 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $1,148.15 | Professional | 54 · Surgery only | $691.83 | $724.44 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $229.09 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $151.36 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $1,071.52 |
Where Tennessee sits
The same service costs 4.6 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· 10th of 51
$1,950
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.