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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $812.83 | Professional | None | $524.81 | $691.83 | $812.83 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,548.82 Median $3,090.30 Typical High $6,760.83 | Facility | None | $1,548.82 | $3,090.30 | $6,760.83 |
BCBS Tennessee Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,412.54 | Professional | None | $645.65 | $851.14 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,691.53 Typical High $5,011.87 | Facility | None | $588.84 | $2,691.53 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,288.25 | Professional | None | $575.44 | $691.83 | $1,288.25 |
Lucent Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,786.30 | Professional | None | $4,466.84 | $4,466.84 | $4,786.30 |
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 $575.44 Median $812.83 Typical High $1,288.25 | Professional | None | $575.44 | $812.83 | $1,288.25 |
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 $263.03 Median $346.74 Typical High $407.38 | Professional | 52 · Reduced service | $263.03 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $138.04 Typical High $162.18 | Professional | 53 · Discontinued | $104.71 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $524.81 Typical High $616.60 | Professional | 54 · Surgery only | $398.11 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $104.71 Typical High $123.03 | Professional | 55 · Aftercare only | $79.43 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $69.18 Typical High $81.28 | Professional | 56 · Pre-op care only | $52.48 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $489.78 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $371.54 | $489.78 | $575.44 |
Where Tennessee sits
The same service costs 6.2 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· 4th of 51
$1,585
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.