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 $851.14 Median $870.96 Typical High $1,288.25 | Professional | None | $851.14 | $870.96 | $1,288.25 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,570.40 Typical High $6,309.57 | Facility | None | $1,071.52 | $2,570.40 | $6,309.57 |
BCBS Tennessee Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $2,089.30 | Professional | None | $912.01 | $1,230.27 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,884.03 Typical High $5,888.44 | Facility | None | $588.84 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,778.28 | Professional | None | $812.83 | $1,023.29 | $1,778.28 |
Lucent Health Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,606.93 | Professional | None | $6,309.57 | $6,309.57 | $6,606.93 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $7,413.10 | Facility | None | $1,000.00 | $2,570.40 | $7,413.10 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $1,905.46 | Professional | None | $812.83 | $1,230.27 | $1,905.46 |
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 $426.58 Median $436.52 Typical High $630.96 | Professional | 52 · Reduced service | $426.58 | $436.52 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $173.78 Typical High $257.04 | Professional | 53 · Discontinued | $169.82 | $173.78 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $954.99 | Professional | 54 · Surgery only | $645.65 | $660.69 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $190.55 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $87.10 Typical High $128.82 | Professional | 56 · Pre-op care only | $85.11 | $87.10 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $891.25 |
Where Tennessee sits
The same service costs 5.8 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
$1,738
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.