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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $870.96 | Professional | None | $537.03 | $645.65 | $870.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $851.14 Median $1,621.81 Typical High $3,548.13 | Facility | None | $851.14 | $1,621.81 | $3,548.13 |
BCBS Tennessee Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $912.01 | Professional | None | $549.54 | $645.65 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,348.96 Typical High $3,311.31 | Facility | None | $741.31 | $1,348.96 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $831.76 | Professional | None | $426.58 | $512.86 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,265.80 | Professional | None | $4,168.69 | $4,168.69 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $1,000.00 | Professional | None | $489.78 | $616.60 | $1,000.00 |
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 $269.15 Median $275.42 Typical High $398.11 | Professional | 52 · Reduced service | $269.15 | $275.42 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $109.65 Typical High $158.49 | Professional | 53 · Discontinued | $107.15 | $109.65 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $602.56 | Professional | 54 · Surgery only | $398.11 | $416.87 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $120.23 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $54.95 Typical High $79.43 | Professional | 56 · Pre-op care only | $53.70 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $389.05 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $371.54 | $389.05 | $562.34 |
Where Tennessee sits
The same service costs 8.5 times more in Wyoming 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· 5th of 51
$1,230
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.