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 $1,380.38 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,380.38 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $794.33 | Professional | None | $407.38 | $562.34 | $794.33 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,348.96 | Professional | None | $512.86 | $724.44 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $3,235.94 | Facility | None | $602.56 | $1,778.28 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $1,174.90 | Professional | None | $436.52 | $602.56 | $1,174.90 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,623.41 | Professional | None | $4,677.35 | $4,677.35 | $5,623.41 |
United Setting Facility Modifier None Typical Low $977.24 Median $2,570.40 Typical High $5,128.61 | Facility | None | $977.24 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $446.68 Median $724.44 Typical High $1,288.25 | Professional | None | $446.68 | $724.44 | $1,288.25 |
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 $186.21 Median $281.84 Typical High $389.05 | Professional | 52 · Reduced service | $186.21 | $281.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $112.20 Typical High $154.88 | Professional | 53 · Discontinued | $74.13 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $416.87 Typical High $575.44 | Professional | 54 · Surgery only | $275.42 | $416.87 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $83.18 Typical High $114.82 | Professional | 55 · Aftercare only | $56.23 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $56.23 Typical High $77.62 | Professional | 56 · Pre-op care only | $37.15 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $389.05 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $257.04 | $389.05 | $537.03 |
Where Tennessee sits
The same service costs 4.1 times more in Alaska 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· 15th of 51
$955
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.