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 $1,380.38 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,380.38 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,288.25 Typical High $2,137.96 | Professional | None | $371.54 | $1,288.25 | $2,137.96 |
BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,995.26 | $5,128.61 |
BCBS Setting Professional Modifier None Typical Low $407.38 Median $1,071.52 Typical High $2,089.30 | Professional | None | $407.38 | $1,071.52 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,995.26 Typical High $3,630.78 | Facility | None | $616.60 | $1,995.26 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $870.96 Typical High $2,137.96 | Professional | None | $398.11 | $870.96 | $2,137.96 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $11,748.98 | Professional | None | $8,317.64 | $8,317.64 | $11,748.98 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $8,709.64 | Facility | None | $1,202.26 | $3,801.89 | $8,709.64 |
United Setting Professional Modifier None Typical Low $407.38 Median $1,202.26 Typical High $2,570.40 | Professional | None | $407.38 | $1,202.26 | $2,570.40 |
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 $181.97 Median $338.84 Typical High $1,071.52 | Professional | 52 · Reduced service | $181.97 | $338.84 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $138.04 Typical High $436.52 | Professional | 53 · Discontinued | $74.13 | $138.04 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $512.86 Typical High $1,621.81 | Professional | 54 · Surgery only | $275.42 | $512.86 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $102.33 Typical High $323.59 | Professional | 55 · Aftercare only | $54.95 | $102.33 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $69.18 Typical High $213.80 | Professional | 56 · Pre-op care only | $37.15 | $69.18 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $478.63 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $257.04 | $478.63 | $1,513.56 |
Where Tennessee sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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
$1,738
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.