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 $2,454.71 Median $4,168.69 Typical High $7,585.78 | Facility | None | $2,454.71 | $4,168.69 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,230.27 | $2,238.72 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,621.81 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,318.26 | $2,290.87 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,709.64 | Professional | None | $8,317.64 | $8,317.64 | $8,709.64 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,584.89 | $2,570.40 |
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 $549.54 Median $616.60 Typical High $758.58 | Professional | 52 · Reduced service | $549.54 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $251.19 Typical High $302.00 | Professional | 53 · Discontinued | $218.78 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $831.76 | $933.25 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $229.09 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $123.03 Typical High $151.36 | Professional | 56 · Pre-op care only | $109.65 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $870.96 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $776.25 | $870.96 | $1,071.52 |
Where Tennessee sits
The same service costs 5.8 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· 19th of 51
$1,622
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.