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 $1,621.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,621.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $1,479.11 | Professional | None | $616.60 | $691.83 | $1,479.11 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,230.27 Median $2,570.40 Typical High $6,309.57 | Facility | None | $1,230.27 | $2,570.40 | $6,309.57 |
BCBS Tennessee Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,513.56 | Professional | None | $660.69 | $891.25 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,818.38 Typical High $5,888.44 | Facility | None | $602.56 | $2,818.38 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,288.25 | Professional | None | $588.84 | $741.31 | $1,288.25 |
Lucent Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,623.41 | $5,623.41 | $5,623.41 |
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 $588.84 Median $870.96 Typical High $1,412.54 | Professional | None | $588.84 | $870.96 | $1,412.54 |
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 $309.03 Median $346.74 Typical High $426.58 | Professional | 52 · Reduced service | $309.03 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $138.04 Typical High $169.82 | Professional | 53 · Discontinued | $123.03 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $512.86 Typical High $630.96 | Professional | 54 · Surgery only | $457.09 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $102.33 Typical High $125.89 | Professional | 55 · Aftercare only | $91.20 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $85.11 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $478.63 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $426.58 | $478.63 | $588.84 |
Where Tennessee sits
The same service costs 5.4 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· 7th 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.