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 $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,288.25 | Professional | None | $794.33 | $1,174.90 | $1,288.25 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,412.54 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Lucent Health Setting Professional Modifier None Typical Low $7,762.47 Median $10,232.93 Typical High $10,232.93 | Professional | None | $7,762.47 | $10,232.93 | $10,232.93 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,288.25 | $2,398.83 |
4 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 54 · Surgery only Typical Low $588.84 Median $870.96 Typical High $954.99 | Professional | 54 · Surgery only | $588.84 | $870.96 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $173.78 Typical High $190.55 | Professional | 55 · Aftercare only | $120.23 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $117.49 Typical High $128.82 | Professional | 56 · Pre-op care only | $79.43 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $812.83 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $549.54 | $812.83 | $891.25 |
Where Tennessee sits
The same service costs 16.2 times more in Alaska than in Texas. 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· 18th of 51
$1,349
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.