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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $724.44 | Professional | None | $331.13 | $478.63 | $724.44 |
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 $354.81 Median $512.86 Typical High $776.25 | Professional | None | $354.81 | $512.86 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,737.80 Typical High $3,235.94 | Facility | None | $524.81 | $1,737.80 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $794.33 | Professional | None | $346.74 | $489.78 | $794.33 |
Lucent Health Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,570.88 | Professional | None | $3,801.89 | $3,801.89 | $4,570.88 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $870.96 | Professional | None | $346.74 | $501.19 | $870.96 |
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 $162.18 Median $234.42 Typical High $346.74 | Professional | 52 · Reduced service | $162.18 | $234.42 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $93.33 Typical High $138.04 | Professional | 53 · Discontinued | $66.07 | $93.33 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $354.81 Typical High $512.86 | Professional | 54 · Surgery only | $245.47 | $354.81 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $70.79 Typical High $102.33 | Professional | 55 · Aftercare only | $48.98 | $70.79 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $46.77 Typical High $69.18 | Professional | 56 · Pre-op care only | $33.11 | $46.77 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $331.13 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $229.09 | $331.13 | $478.63 |
Where Tennessee sits
The same service costs 4.4 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· 19th of 51
$692
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.