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 $977.24 Median $1,071.52 Typical High $1,412.54 | Professional | None | $977.24 | $1,071.52 | $1,412.54 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,122.02 Median $3,090.30 Typical High $8,317.64 | Facility | None | $1,122.02 | $3,090.30 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,412.54 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $6,760.83 Typical High $14,454.40 | Facility | None | $524.81 | $6,760.83 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,737.80 | Professional | None | $954.99 | $1,230.27 | $1,737.80 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $8,317.64 | Professional | None | $7,585.78 | $7,585.78 | $8,317.64 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $2,137.96 | Professional | None | $851.14 | $1,148.15 | $2,137.96 |
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 $489.78 Median $489.78 Typical High $676.08 | Professional | 52 · Reduced service | $489.78 | $489.78 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $269.15 | Professional | 53 · Discontinued | $194.98 | $199.53 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $741.31 Typical High $1,023.29 | Professional | 54 · Surgery only | $724.44 | $741.31 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $204.17 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $134.90 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $954.99 |
Where Tennessee sits
The same service costs 6.2 times more in Alaska 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· 19th of 51
$1,622
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.