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 $912.01 Median $954.99 Typical High $2,089.30 | Professional | None | $912.01 | $954.99 | $2,089.30 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,288.25 Median $4,897.79 Typical High $10,471.29 | Facility | None | $1,288.25 | $4,897.79 | $10,471.29 |
BCBS Tennessee Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $2,238.72 | Professional | None | $977.24 | $1,288.25 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,128.61 Typical High $10,715.19 | Facility | None | $602.56 | $5,128.61 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,905.46 | Professional | None | $870.96 | $1,122.02 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $7,244.36 | Professional | None | $6,918.31 | $6,918.31 | $7,244.36 |
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 $891.25 Median $1,348.96 Typical High $2,089.30 | Professional | None | $891.25 | $1,348.96 | $2,089.30 |
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 $457.09 Median $478.63 Typical High $691.83 | Professional | 52 · Reduced service | $457.09 | $478.63 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $190.55 Typical High $275.42 | Professional | 53 · Discontinued | $186.21 | $190.55 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $707.95 Typical High $1,023.29 | Professional | 54 · Surgery only | $691.83 | $707.95 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $141.25 Typical High $204.17 | Professional | 55 · Aftercare only | $138.04 | $141.25 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $138.04 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $660.69 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $645.65 | $660.69 | $954.99 |
Where Tennessee sits
The same service costs 6.3 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· 7th of 51
$2,089
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.