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 $2,344.23 Median $4,570.88 Typical High $10,715.19 | Facility | None | $2,344.23 | $4,570.88 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,148.15 | $1,621.81 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $8,317.64 | Facility | None | $1,513.56 | $3,715.35 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,737.80 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,630.78 Typical High $6,606.93 | Facility | None | $1,174.90 | $3,630.78 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,348.96 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $10,232.93 | Professional | None | $9,332.54 | $9,332.54 | $10,232.93 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,174.90 | $1,659.59 | $2,691.53 |
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 $524.81 Median $575.44 Typical High $812.83 | Professional | 52 · Reduced service | $524.81 | $575.44 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $229.09 Typical High $323.59 | Professional | 53 · Discontinued | $208.93 | $229.09 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $851.14 Typical High $1,230.27 | Professional | 54 · Surgery only | $776.25 | $851.14 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $169.82 Typical High $245.47 | Professional | 55 · Aftercare only | $154.88 | $169.82 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $114.82 Typical High $162.18 | Professional | 56 · Pre-op care only | $104.71 | $114.82 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $794.33 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $724.44 | $794.33 | $1,148.15 |
Where Tennessee sits
The same service costs 6.2 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· 9th of 51
$2,692
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.