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 $125.89 Median $1,949.84 Typical High $6,606.93 | Facility | None | $125.89 | $1,949.84 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $213.80 | Professional | None | $83.18 | $125.89 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $144.54 | Professional | None | $54.95 | $75.86 | $144.54 |
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 $104.71 Median $151.36 Typical High $223.87 | Professional | None | $104.71 | $151.36 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $239.88 Typical High $1,659.59 | Facility | None | $123.03 | $239.88 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $218.78 | Professional | None | $87.10 | $128.82 | $218.78 |
Lucent Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,348.96 | Professional | None | $1,122.02 | $1,122.02 | $1,348.96 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,737.80 | Facility | None | $107.15 | $436.52 | $1,737.80 |
United Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $245.47 | Professional | None | $97.72 | $144.54 | $245.47 |
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 $60.26 Typical High $83.18 | Professional | 52 · Reduced service | $40.74 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $24.55 Typical High $33.11 | Professional | 53 · Discontinued | $16.22 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $91.20 Typical High $123.03 | Professional | 54 · Surgery only | $60.26 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $18.20 Typical High $24.55 | Professional | 55 · Aftercare only | $12.02 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.02 Typical High $16.60 | Professional | 56 · Pre-op care only | $8.13 | $12.02 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $85.11 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $56.23 | $85.11 | $114.82 |
Where Tennessee sits
The same service costs 3.7 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· 18th of 51
$170
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.