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 $218.78 Median $239.88 Typical High $338.84 | Professional | None | $218.78 | $239.88 | $338.84 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,137.96 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $501.19 | Professional | None | $223.87 | $269.15 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,819.70 Typical High $3,311.31 | Facility | None | $741.31 | $1,819.70 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $389.05 | Professional | None | $229.09 | $229.09 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,905.46 | Professional | None | $1,819.70 | $1,819.70 | $1,905.46 |
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 $213.80 Median $263.03 Typical High $501.19 | Professional | None | $213.80 | $263.03 | $501.19 |
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 $109.65 Median $120.23 Typical High $162.18 | Professional | 52 · Reduced service | $109.65 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $47.86 Typical High $66.07 | Professional | 53 · Discontinued | $43.65 | $47.86 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $177.83 Typical High $245.47 | Professional | 54 · Surgery only | $162.18 | $177.83 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $35.48 Typical High $48.98 | Professional | 55 · Aftercare only | $32.36 | $35.48 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.99 Typical High $33.11 | Professional | 56 · Pre-op care only | $21.88 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $165.96 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $151.36 | $165.96 | $229.09 |
Where Tennessee sits
The same service costs 6.0 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· 24th of 51
$331
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.