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 $407.38 Median $426.58 Typical High $616.60 | Professional | None | $407.38 | $426.58 | $616.60 |
BCBS Tennessee Setting Facility Modifier None Typical Low $831.76 Median $1,584.89 Typical High $3,467.37 | Facility | None | $831.76 | $1,584.89 | $3,467.37 |
BCBS Tennessee Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $1,000.00 | Professional | None | $446.68 | $588.84 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,174.90 Typical High $2,187.76 | Facility | None | $389.05 | $1,174.90 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $851.14 | Professional | None | $389.05 | $489.78 | $851.14 |
Lucent Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,311.31 | Professional | None | $3,090.30 | $3,090.30 | $3,311.31 |
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 $398.11 Median $588.84 Typical High $933.25 | Professional | None | $398.11 | $588.84 | $933.25 |
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 $204.17 Median $208.93 Typical High $309.03 | Professional | 52 · Reduced service | $204.17 | $208.93 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $123.03 | Professional | 53 · Discontinued | $81.28 | $85.11 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $316.23 Typical High $457.09 | Professional | 54 · Surgery only | $309.03 | $316.23 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $63.10 Typical High $91.20 | Professional | 55 · Aftercare only | $61.66 | $63.10 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $295.12 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $288.40 | $295.12 | $426.58 |
Where Tennessee sits
The same service costs 5.1 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· 5th of 51
$1,047
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.