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 $3,090.30 Typical High $7,585.78 | Facility | None | $2,454.71 | $3,090.30 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $776.25 | Professional | None | $562.34 | $630.96 | $776.25 |
BCBS Tennessee Setting Facility Modifier None Typical Low $977.24 Median $2,398.83 Typical High $6,309.57 | Facility | None | $977.24 | $2,398.83 | $6,309.57 |
BCBS Tennessee Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,412.54 | Professional | None | $616.60 | $831.76 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,691.53 Typical High $5,011.87 | Facility | None | $588.84 | $2,691.53 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,174.90 | Professional | None | $537.03 | $676.08 | $1,174.90 |
Lucent Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $1,318.26 | Professional | None | $549.54 | $812.83 | $1,318.26 |
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 $281.84 Median $316.23 Typical High $389.05 | Professional | 52 · Reduced service | $281.84 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $154.88 | Professional | 53 · Discontinued | $112.20 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $478.63 Typical High $588.84 | Professional | 54 · Surgery only | $426.58 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $95.50 Typical High $117.49 | Professional | 55 · Aftercare only | $85.11 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $77.62 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $446.68 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $398.11 | $446.68 | $549.54 |
Where Tennessee sits
The same service costs 9.8 times more in Oklahoma 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· 5th of 51
$1,479
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.