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 $257.04 Median $346.74 Typical High $537.03 | Professional | None | $257.04 | $346.74 | $537.03 |
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 $331.13 Median $457.09 Typical High $831.76 | Professional | None | $331.13 | $457.09 | $831.76 |
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 $263.03 Median $380.19 Typical High $676.08 | Professional | None | $263.03 | $380.19 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,311.31 | Professional | None | $2,691.53 | $2,691.53 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $794.33 | Professional | None | $288.40 | $457.09 | $794.33 |
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 $128.82 Median $173.78 Typical High $257.04 | Professional | 52 · Reduced service | $128.82 | $173.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $70.79 Typical High $104.71 | Professional | 53 · Discontinued | $52.48 | $70.79 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $263.03 Typical High $389.05 | Professional | 54 · Surgery only | $194.98 | $263.03 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $52.48 Typical High $77.62 | Professional | 55 · Aftercare only | $38.90 | $52.48 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $34.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $25.70 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $245.47 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $181.97 | $245.47 | $363.08 |
Where Tennessee sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 13th of 51
$603
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.