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 $4,570.88 Typical High $20,417.38 | Facility | None | $2,454.71 | $4,570.88 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,479.11 | Professional | None | $954.99 | $1,258.93 | $1,479.11 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,819.70 Median $4,897.79 Typical High $10,471.29 | Facility | None | $1,819.70 | $4,897.79 | $10,471.29 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,621.81 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $5,495.41 Typical High $11,220.18 | Facility | None | $831.76 | $5,495.41 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,230.27 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,548.82 | $2,398.83 |
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 $478.63 Median $630.96 Typical High $741.31 | Professional | 52 · Reduced service | $478.63 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $251.19 Typical High $295.12 | Professional | 53 · Discontinued | $190.55 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $954.99 Typical High $1,122.02 | Professional | 54 · Surgery only | $724.44 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $190.55 Typical High $223.87 | Professional | 55 · Aftercare only | $144.54 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $95.50 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $891.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $676.08 | $891.25 | $1,047.13 |
Where Tennessee sits
The same service costs 8.7 times more in Oklahoma 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· 9th of 51
$2,455
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.