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 $1,479.11 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,479.11 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $245.47 | Professional | None | $151.36 | $204.17 | $245.47 |
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 $186.21 Median $245.47 Typical High $407.38 | Professional | None | $186.21 | $245.47 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $2,754.23 | Facility | None | $588.84 | $1,548.82 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $371.54 | Professional | None | $165.96 | $199.53 | $371.54 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,318.26 | $1,318.26 | $1,380.38 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $380.19 | Professional | None | $162.18 | $229.09 | $380.19 |
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 $75.86 Median $100.00 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $30.90 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $114.82 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $22.91 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $107.15 | $141.25 | $165.96 |
Where Tennessee sits
The same service costs 8.7 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· 2nd of 51
$871
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.