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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $724.44 | Professional | None | $467.74 | $616.60 | $724.44 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,445.44 Typical High $3,715.35 | Facility | None | $501.19 | $1,445.44 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,258.93 | Professional | None | $575.44 | $758.58 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $1,148.15 | Professional | None | $512.86 | $616.60 | $1,148.15 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Professional | None | $8,317.64 | $8,317.64 | $8,317.64 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $1,174.90 | Professional | None | $512.86 | $707.95 | $1,174.90 |
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 $234.42 Median $309.03 Typical High $363.08 | Professional | 52 · Reduced service | $234.42 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $125.89 Typical High $147.91 | Professional | 53 · Discontinued | $93.33 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $467.74 Typical High $549.54 | Professional | 54 · Surgery only | $354.81 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $93.33 Typical High $109.65 | Professional | 55 · Aftercare only | $70.79 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $61.66 Typical High $72.44 | Professional | 56 · Pre-op care only | $46.77 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $436.52 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $331.13 | $436.52 | $512.86 |
Where Tennessee sits
The same service costs 6.0 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· 11th of 51
$1,000
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.