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 $891.25 Median $2,818.38 Typical High $7,585.78 | Facility | None | $891.25 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $1,174.90 | Professional | None | $724.44 | $758.58 | $1,174.90 |
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 $794.33 Median $1,071.52 Typical High $1,778.28 | Professional | None | $794.33 | $1,071.52 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $3,715.35 | Facility | None | $602.56 | $2,041.74 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,513.56 | Professional | None | $691.83 | $870.96 | $1,513.56 |
Lucent Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,754.40 | Professional | None | $5,623.41 | $5,623.41 | $5,754.40 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,709.64 | Facility | None | $1,548.82 | $4,570.88 | $8,709.64 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,659.59 | Professional | None | $707.95 | $1,047.13 | $1,659.59 |
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 $363.08 Median $371.54 Typical High $549.54 | Professional | 52 · Reduced service | $363.08 | $371.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $218.78 | Professional | 53 · Discontinued | $144.54 | $151.36 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $812.83 | Professional | 54 · Surgery only | $549.54 | $562.34 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $162.18 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $75.86 Typical High $109.65 | Professional | 56 · Pre-op care only | $72.44 | $75.86 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $758.58 |
Where Tennessee sits
The same service costs 7.9 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· 10th of 51
$1,660
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.