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 $1,513.56 Median $2,951.21 Typical High $6,606.93 | Facility | None | $1,513.56 | $2,951.21 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $1,148.15 | Professional | None | $616.60 | $691.83 | $1,148.15 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,412.54 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,412.54 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,778.28 | Professional | None | $812.83 | $1,071.52 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,090.30 Typical High $6,606.93 | Facility | None | $588.84 | $3,090.30 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,412.54 | Professional | None | $707.95 | $912.01 | $1,412.54 |
Lucent Health Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $6,309.57 | Professional | None | $5,495.41 | $5,495.41 | $6,309.57 |
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 $724.44 Median $1,023.29 Typical High $1,621.81 | Professional | None | $724.44 | $1,023.29 | $1,621.81 |
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 $309.03 Median $346.74 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $138.04 Typical High $141.25 | Professional | 53 · Discontinued | $123.03 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $512.86 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $70.79 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $478.63 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $478.63 | $501.19 |
Where Tennessee sits
The same service costs 10.5 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.