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 $794.33 Median $891.25 Typical High $1,621.81 | Professional | None | $794.33 | $891.25 | $1,621.81 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,445.44 Typical High $3,715.35 | Facility | None | $501.19 | $1,445.44 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,995.26 | Professional | None | $870.96 | $1,148.15 | $1,995.26 |
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 $758.58 Median $954.99 Typical High $1,659.59 | Professional | None | $758.58 | $954.99 | $1,659.59 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
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 $776.25 Median $1,122.02 Typical High $1,862.09 | Professional | None | $776.25 | $1,122.02 | $1,862.09 |
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 $398.11 Median $446.68 Typical High $549.54 | Professional | 52 · Reduced service | $398.11 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $177.83 Typical High $218.78 | Professional | 53 · Discontinued | $158.49 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $676.08 Typical High $831.76 | Professional | 54 · Surgery only | $602.56 | $676.08 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $134.90 Typical High $165.96 | Professional | 55 · Aftercare only | $120.23 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $89.13 Typical High $109.65 | Professional | 56 · Pre-op care only | $79.43 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $630.96 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $562.34 | $630.96 | $776.25 |
Where Tennessee sits
The same service costs 6.2 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· 21st of 51
$1,288
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.