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 $467.74 Median $630.96 Typical High $724.44 | Professional | None | $467.74 | $630.96 | $724.44 |
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 $489.78 Median $602.56 Typical High $831.76 | Professional | None | $489.78 | $602.56 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,137.96 Typical High $3,801.89 | Facility | None | $831.76 | $2,137.96 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $758.58 | Professional | None | $371.54 | $467.74 | $758.58 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
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 $457.09 Median $588.84 Typical High $891.25 | Professional | None | $457.09 | $588.84 | $891.25 |
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 $234.42 Median $257.04 Typical High $354.81 | Professional | 52 · Reduced service | $234.42 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $141.25 | Professional | 53 · Discontinued | $95.50 | $102.33 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $537.03 | Professional | 54 · Surgery only | $354.81 | $389.05 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $107.15 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $51.29 Typical High $70.79 | Professional | 56 · Pre-op care only | $46.77 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $363.08 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $331.13 | $363.08 | $501.19 |
Where Tennessee sits
The same service costs 7.9 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
$1,202
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.