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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $630.96 | Professional | None | $407.38 | $446.68 | $630.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $5,128.61 | Facility | None | $933.25 | $1,905.46 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $891.25 | Professional | None | $407.38 | $478.63 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,659.59 Typical High $3,235.94 | Facility | None | $389.05 | $1,659.59 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $707.95 | Professional | None | $389.05 | $416.87 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,715.35 | Professional | None | $3,311.31 | $3,311.31 | $3,715.35 |
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 $354.81 Median $446.68 Typical High $912.01 | Professional | None | $354.81 | $446.68 | $912.01 |
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 $204.17 Median $218.78 Typical High $309.03 | Professional | 52 · Reduced service | $204.17 | $218.78 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $123.03 | Professional | 53 · Discontinued | $81.28 | $87.10 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $467.74 | Professional | 54 · Surgery only | $309.03 | $323.59 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $93.33 | Professional | 55 · Aftercare only | $61.66 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $61.66 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $436.52 |
Where Tennessee sits
The same service costs 6.2 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· 21st 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.