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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $338.84 | Professional | None | $199.53 | $229.09 | $338.84 |
BCBS Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $380.19 | Professional | None | $218.78 | $269.15 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $302.00 Typical High $1,659.59 | Facility | None | $154.88 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $338.84 | Professional | None | $177.83 | $199.53 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,737.80 | $1,737.80 | $2,187.76 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,737.80 | Facility | None | $107.15 | $436.52 | $1,737.80 |
United Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $407.38 | Professional | None | $199.53 | $257.04 | $407.38 |
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 $100.00 Median $112.20 Typical High $169.82 | Professional | 52 · Reduced service | $100.00 | $112.20 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $45.71 Typical High $67.61 | Professional | 53 · Discontinued | $39.81 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $169.82 Typical High $257.04 | Professional | 54 · Surgery only | $151.36 | $169.82 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.88 Typical High $51.29 | Professional | 55 · Aftercare only | $30.20 | $33.88 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $22.39 Typical High $33.88 | Professional | 56 · Pre-op care only | $19.95 | $22.39 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $158.49 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $141.25 | $158.49 | $239.88 |
Where Tennessee sits
The same service costs 4.3 times more in Alaska than in Florida. 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· 22nd of 51
$302
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.