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 $2,454.71 Median $3,090.30 Typical High $7,585.78 | Facility | None | $2,454.71 | $3,090.30 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,513.56 | Professional | None | $933.25 | $1,122.02 | $1,513.56 |
BCBS Tennessee Setting Facility Modifier None Typical Low $954.99 Median $1,698.24 Typical High $3,715.35 | Facility | None | $954.99 | $1,698.24 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,584.89 | Professional | None | $954.99 | $1,148.15 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,584.89 Typical High $3,801.89 | Facility | None | $831.76 | $1,584.89 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,445.44 | Professional | None | $724.44 | $891.25 | $1,445.44 |
Lucent Health Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,244.36 | Professional | None | $7,079.46 | $7,079.46 | $7,244.36 |
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 $851.14 Median $1,047.13 Typical High $1,737.80 | Professional | None | $851.14 | $1,047.13 | $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 $467.74 Median $478.63 Typical High $691.83 | Professional | 52 · Reduced service | $467.74 | $478.63 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $190.55 Typical High $275.42 | Professional | 53 · Discontinued | $186.21 | $190.55 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $1,047.13 | Professional | 54 · Surgery only | $691.83 | $724.44 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $208.93 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $95.50 Typical High $138.04 | Professional | 56 · Pre-op care only | $93.33 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $977.24 |
Where Tennessee sits
The same service costs 7.2 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· 15th of 51
$1,514
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.