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 $1,513.56 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,513.56 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $1,513.56 Typical High $2,511.89 | Professional | None | $316.23 | $1,513.56 | $2,511.89 |
BCBS Tennessee 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 Tennessee Setting Professional Modifier None Typical Low $371.54 Median $1,148.15 Typical High $2,511.89 | Professional | None | $371.54 | $1,148.15 | $2,511.89 |
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 $346.74 Median $1,023.29 Typical High $2,398.83 | Professional | None | $346.74 | $1,023.29 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $13,803.84 | Professional | None | $10,232.93 | $10,232.93 | $13,803.84 |
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 $346.74 Median $1,122.02 Typical High $2,884.03 | Professional | None | $346.74 | $1,122.02 | $2,884.03 |
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 $158.49 Median $295.12 Typical High $1,258.93 | Professional | 52 · Reduced service | $158.49 | $295.12 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $117.49 Typical High $501.19 | Professional | 53 · Discontinued | $63.10 | $117.49 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $446.68 Typical High $1,862.09 | Professional | 54 · Surgery only | $239.88 | $446.68 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $89.13 Typical High $380.19 | Professional | 55 · Aftercare only | $47.86 | $89.13 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $58.88 Typical High $251.19 | Professional | 56 · Pre-op care only | $31.62 | $58.88 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $416.87 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $223.87 | $416.87 | $1,737.80 |
Where Tennessee sits
The same service costs 5.8 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· 12th of 51
$1,820
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.