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 $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $724.44 | Professional | None | $489.78 | $501.19 | $724.44 |
BCBS Tennessee Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $5,128.61 | Facility | None | $933.25 | $1,905.46 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $1,174.90 | Professional | None | $524.81 | $707.95 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,778.28 Typical High $3,715.35 | Facility | None | $389.05 | $1,778.28 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $1,000.00 | Professional | None | $467.74 | $575.44 | $1,000.00 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
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 $467.74 Median $707.95 Typical High $1,096.48 | Professional | None | $467.74 | $707.95 | $1,096.48 |
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 $245.47 Median $251.19 Typical High $363.08 | Professional | 52 · Reduced service | $245.47 | $251.19 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $100.00 Typical High $144.54 | Professional | 53 · Discontinued | $97.72 | $100.00 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $549.54 | Professional | 54 · Surgery only | $363.08 | $380.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $109.65 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $72.44 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $512.86 |
Where Tennessee sits
The same service costs 5.5 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· 9th of 51
$1,148
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.