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 $363.08 Median $398.11 Typical High $562.34 | Professional | None | $363.08 | $398.11 | $562.34 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $5,128.61 | Facility | None | $1,122.02 | $2,137.96 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $794.33 | Professional | None | $363.08 | $426.58 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,089.30 Typical High $3,801.89 | Facility | None | $741.31 | $2,089.30 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $660.69 | Professional | None | $389.05 | $436.52 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $4,677.35 | Professional | None | $3,467.37 | $4,677.35 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $831.76 | Professional | None | $363.08 | $426.58 | $831.76 |
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 $181.97 Median $194.98 Typical High $275.42 | Professional | 52 · Reduced service | $181.97 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $79.43 Typical High $109.65 | Professional | 53 · Discontinued | $72.44 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $295.12 Typical High $416.87 | Professional | 54 · Surgery only | $275.42 | $295.12 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $58.88 Typical High $83.18 | Professional | 55 · Aftercare only | $54.95 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $39.81 Typical High $54.95 | Professional | 56 · Pre-op care only | $36.31 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $275.42 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $257.04 | $275.42 | $389.05 |
Where Tennessee sits
The same service costs 5.6 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· 27th of 51
$537
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.