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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $263.03 | Professional | None | $102.33 | $173.78 | $263.03 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $2,630.27 | Facility | None | $524.81 | $1,096.48 | $2,630.27 |
BCBS Tennessee Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $398.11 | Professional | None | $128.82 | $213.80 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $331.13 | Professional | None | $104.71 | $173.78 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,412.54 | $1,412.54 | $1,819.70 |
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 $117.49 Median $208.93 Typical High $389.05 | Professional | None | $117.49 | $208.93 | $389.05 |
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 $51.29 Median $87.10 Typical High $131.83 | Professional | 52 · Reduced service | $51.29 | $87.10 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $35.48 Typical High $52.48 | Professional | 53 · Discontinued | $20.42 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $131.83 Typical High $199.53 | Professional | 54 · Surgery only | $77.62 | $131.83 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $26.30 Typical High $39.81 | Professional | 55 · Aftercare only | $15.49 | $26.30 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $17.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $10.23 | $17.38 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $123.03 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $72.44 | $123.03 | $186.21 |
Where Tennessee sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 17th of 51
$263
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.