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 $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,047.13 | Professional | None | $758.58 | $851.14 | $1,047.13 |
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 $812.83 Median $1,096.48 Typical High $1,862.09 | Professional | None | $812.83 | $1,096.48 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,041.74 Typical High $3,715.35 | Facility | None | $588.84 | $2,041.74 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,584.89 | Professional | None | $724.44 | $912.01 | $1,584.89 |
Lucent Health Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Professional | None | $9,772.37 | $9,772.37 | $9,772.37 |
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 $724.44 Median $1,071.52 Typical High $1,737.80 | Professional | None | $724.44 | $1,071.52 | $1,737.80 |
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 $380.19 Median $426.58 Typical High $524.81 | Professional | 52 · Reduced service | $380.19 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $208.93 | Professional | 53 · Discontinued | $151.36 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $776.25 | Professional | 54 · Surgery only | $562.34 | $630.96 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $154.88 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $104.71 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $724.44 |
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· 14th 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.