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 $1,479.11 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,479.11 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,071.52 | $1,513.56 |
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 $1,000.00 Median $1,258.93 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,258.93 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $3,090.30 | Facility | None | $524.81 | $1,698.24 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,174.90 | $1,819.70 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $8,912.51 | Professional | None | $7,943.28 | $7,943.28 | $8,912.51 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,230.27 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $2,290.87 | Professional | None | $912.01 | $1,096.48 | $2,290.87 |
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 $501.19 Median $537.03 Typical High $758.58 | Professional | 52 · Reduced service | $501.19 | $537.03 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $302.00 | Professional | 53 · Discontinued | $199.53 | $213.80 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $794.33 Typical High $1,122.02 | Professional | 54 · Surgery only | $741.31 | $794.33 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $223.87 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $151.36 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $741.31 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $691.83 | $741.31 | $1,047.13 |
Where Tennessee sits
The same service costs 5.2 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
$1,445
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.