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 $416.87 Median $549.54 Typical High $645.65 | Professional | None | $416.87 | $549.54 | $645.65 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,288.25 Median $3,090.30 Typical High $6,606.93 | Facility | None | $1,288.25 | $3,090.30 | $6,606.93 |
BCBS Tennessee Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,071.52 | Professional | None | $501.19 | $660.69 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,344.23 Typical High $5,011.87 | Facility | None | $524.81 | $2,344.23 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $1,023.29 | Professional | None | $467.74 | $562.34 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
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 $446.68 Median $616.60 Typical High $1,047.13 | Professional | None | $446.68 | $616.60 | $1,047.13 |
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 $208.93 Median $275.42 Typical High $323.59 | Professional | 52 · Reduced service | $208.93 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $109.65 Typical High $128.82 | Professional | 53 · Discontinued | $83.18 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $407.38 Typical High $489.78 | Professional | 54 · Surgery only | $309.03 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $61.66 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $54.95 Typical High $64.57 | Professional | 56 · Pre-op care only | $41.69 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $380.19 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $288.40 | $380.19 | $457.09 |
Where Tennessee sits
The same service costs 6.5 times more in Alaska than in Texas. 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· 8th 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.