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 $109.65 Median $257.04 Typical High $389.05 | Professional | None | $109.65 | $257.04 | $389.05 |
BCBS Tennessee 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 Tennessee Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $363.08 | Professional | None | $120.23 | $223.87 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $204.17 Typical High $389.05 | Facility | None | $50.12 | $204.17 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $194.98 Typical High $346.74 | Professional | None | $97.72 | $194.98 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,187.76 | $2,454.71 | $2,454.71 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $109.65 Median $218.78 Typical High $389.05 | Professional | None | $109.65 | $218.78 | $389.05 |
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 $54.95 Median $109.65 Typical High $194.98 | Professional | 52 · Reduced service | $54.95 | $109.65 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $44.67 Typical High $77.62 | Professional | 53 · Discontinued | $21.88 | $44.67 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $165.96 Typical High $288.40 | Professional | 54 · Surgery only | $81.28 | $165.96 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $33.11 Typical High $58.88 | Professional | 55 · Aftercare only | $16.22 | $33.11 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $22.39 Typical High $38.90 | Professional | 56 · Pre-op care only | $10.96 | $22.39 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $154.88 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $75.86 | $154.88 | $269.15 |
Where Tennessee sits
The same service costs 4.6 times more in Wisconsin than in Kentucky. 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· 12th of 51
$282
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.