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 $91.20 Median $128.82 Typical High $190.55 | Professional | None | $91.20 | $128.82 | $190.55 |
BCBS Tennessee Setting Facility Modifier None Typical Low $870.96 Median $1,621.81 Typical High $3,548.13 | Facility | None | $870.96 | $1,621.81 | $3,548.13 |
BCBS Tennessee Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $281.84 | Professional | None | $104.71 | $144.54 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $208.93 Typical High $2,691.53 | Facility | None | $107.15 | $208.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $234.42 | Professional | None | $89.13 | $128.82 | $234.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,778.28 | $1,778.28 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $257.04 | Professional | None | $89.13 | $144.54 | $257.04 |
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 $45.71 Median $64.57 Typical High $95.50 | Professional | 52 · Reduced service | $45.71 | $64.57 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $25.70 Typical High $38.02 | Professional | 53 · Discontinued | $18.20 | $25.70 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $97.72 Typical High $144.54 | Professional | 54 · Surgery only | $69.18 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.50 Typical High $28.84 | Professional | 55 · Aftercare only | $13.80 | $19.50 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.88 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.12 | $12.88 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $91.20 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $64.57 | $91.20 | $134.90 |
Where Tennessee sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 12th of 51
$191
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.