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 $120.23 Median $1,445.44 Typical High $4,265.80 | Facility | None | $120.23 | $1,445.44 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $181.97 Typical High $288.40 | Professional | None | $81.28 | $181.97 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $295.12 | Professional | None | $102.33 | $169.82 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $263.03 Typical High $501.19 | Facility | None | $50.12 | $263.03 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $346.74 | Professional | None | $112.20 | $181.97 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,778.28 | $1,778.28 | $2,344.23 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $97.72 Median $173.78 Typical High $302.00 | Professional | None | $97.72 | $173.78 | $302.00 |
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 $40.74 Median $63.10 Typical High $128.82 | Professional | 52 · Reduced service | $40.74 | $63.10 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $25.12 Typical High $51.29 | Professional | 53 · Discontinued | $16.22 | $25.12 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $93.33 Typical High $190.55 | Professional | 54 · Surgery only | $60.26 | $93.33 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $18.62 Typical High $38.90 | Professional | 55 · Aftercare only | $12.02 | $18.62 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.59 Typical High $25.70 | Professional | 56 · Pre-op care only | $8.13 | $12.59 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $87.10 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $56.23 | $87.10 | $177.83 |
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· 16th of 51
$263
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.