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 $794.33 Median $812.83 Typical High $1,288.25 | Professional | None | $794.33 | $812.83 | $1,288.25 |
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 $870.96 Median $1,174.90 Typical High $1,949.84 | Professional | None | $870.96 | $1,174.90 | $1,949.84 |
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 $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 $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,456.54 | Facility | None | $1,202.26 | $3,801.89 | $6,456.54 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,819.70 | Professional | None | $776.25 | $1,148.15 | $1,819.70 |
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 $407.38 Typical High $602.56 | Professional | 52 · Reduced service | $398.11 | $407.38 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $165.96 Typical High $239.88 | Professional | 53 · Discontinued | $158.49 | $165.96 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $891.25 | Professional | 54 · Surgery only | $602.56 | $616.60 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $123.03 Typical High $177.83 | Professional | 55 · Aftercare only | $120.23 | $123.03 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $81.28 Typical High $120.23 | Professional | 56 · Pre-op care only | $79.43 | $81.28 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $575.44 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $562.34 | $575.44 | $831.76 |
Where Tennessee sits
The same service costs 6.6 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· 11th of 51
$1,585
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.