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 $1,096.48 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,096.48 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $1,348.96 | Professional | None | $512.86 | $562.34 | $1,348.96 |
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 $602.56 Median $812.83 Typical High $1,380.38 | Professional | None | $602.56 | $812.83 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,311.31 Typical High $6,606.93 | Facility | None | $741.31 | $3,311.31 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,174.90 | Professional | None | $616.60 | $741.31 | $1,174.90 |
Lucent Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
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 $549.54 Median $794.33 Typical High $1,318.26 | Professional | None | $549.54 | $794.33 | $1,318.26 |
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 $257.04 Median $257.04 Typical High $380.19 | Professional | 52 · Reduced service | $257.04 | $257.04 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $151.36 | Professional | 53 · Discontinued | $102.33 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $389.05 Typical High $575.44 | Professional | 54 · Surgery only | $380.19 | $389.05 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $77.62 Typical High $114.82 | Professional | 55 · Aftercare only | $75.86 | $77.62 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $75.86 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $363.08 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $354.81 | $363.08 | $537.03 |
Where Tennessee sits
The same service costs 8.1 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· 8th of 51
$1,738
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.