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 $1,148.15 Median $2,951.21 Typical High $7,585.78 | Facility | None | $1,148.15 | $2,951.21 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,862.09 | Professional | None | $691.83 | $912.01 | $1,862.09 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,513.56 Median $4,897.79 Typical High $10,471.29 | Facility | None | $1,513.56 | $4,897.79 | $10,471.29 |
BCBS Tennessee Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,905.46 | Professional | None | $870.96 | $1,148.15 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $5,370.32 Typical High $11,220.18 | Facility | None | $588.84 | $5,370.32 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,698.24 | Professional | None | $758.58 | $912.01 | $1,698.24 |
Lucent Health Setting Professional Modifier None Typical Low $5,888.44 Median $6,165.95 Typical High $6,165.95 | Professional | None | $5,888.44 | $6,165.95 | $6,165.95 |
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 $776.25 Median $1,148.15 Typical High $1,737.80 | Professional | None | $776.25 | $1,148.15 | $1,737.80 |
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 $346.74 Median $457.09 Typical High $537.03 | Professional | 52 · Reduced service | $346.74 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $181.97 Typical High $213.80 | Professional | 53 · Discontinued | $138.04 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $691.83 Typical High $812.83 | Professional | 54 · Surgery only | $524.81 | $691.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $138.04 Typical High $162.18 | Professional | 55 · Aftercare only | $104.71 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $91.20 Typical High $107.15 | Professional | 56 · Pre-op care only | $69.18 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $645.65 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $489.78 | $645.65 | $758.58 |
Where Tennessee sits
The same service costs 11.0 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· 6th of 51
$2,042
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.