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 $1,258.93 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,513.56 | $1,949.84 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $5,128.61 | Facility | None | $1,122.02 | $2,137.96 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,445.44 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,630.27 Typical High $4,786.30 | Facility | None | $831.76 | $2,630.27 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,905.46 | Professional | None | $977.24 | $1,148.15 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Professional | None | $10,964.78 | $10,964.78 | $10,964.78 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,380.38 | $2,187.76 |
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 $616.60 Median $660.69 Typical High $933.25 | Professional | 52 · Reduced service | $616.60 | $660.69 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $371.54 | Professional | 53 · Discontinued | $251.19 | $263.03 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $1,412.54 | Professional | 54 · Surgery only | $933.25 | $977.24 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $281.84 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $186.21 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $1,318.26 |
Where Tennessee sits
The same service costs 7.1 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· 20th of 51
$1,862
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.