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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $269.15 | Professional | None | $117.49 | $173.78 | $269.15 |
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 $151.36 Median $239.88 Typical High $457.09 | Professional | None | $151.36 | $239.88 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $363.08 Typical High $2,691.53 | Facility | None | $186.21 | $363.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $389.05 | Professional | None | $125.89 | $199.53 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,548.82 | $1,548.82 | $1,862.09 |
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 $131.83 Median $223.87 Typical High $416.87 | Professional | None | $131.83 | $223.87 | $416.87 |
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 $53.70 Median $87.10 Typical High $131.83 | Professional | 52 · Reduced service | $53.70 | $87.10 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $34.67 Typical High $52.48 | Professional | 53 · Discontinued | $21.88 | $34.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $131.83 Typical High $194.98 | Professional | 54 · Surgery only | $81.28 | $131.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $26.30 Typical High $39.81 | Professional | 55 · Aftercare only | $16.22 | $26.30 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $17.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $10.72 | $17.38 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $123.03 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $75.86 | $123.03 | $181.97 |
Where Tennessee sits
The same service costs 3.5 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· 16th of 51
$275
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.