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 $812.83 Median $2,398.83 Typical High $7,585.78 | Facility | None | $812.83 | $2,398.83 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $190.55 | Professional | None | $83.18 | $114.82 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $138.04 Typical High $141.25 | Professional | None | $131.83 | $138.04 | $141.25 |
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 $100.00 Median $141.25 Typical High $204.17 | Professional | None | $100.00 | $141.25 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $234.42 Typical High $1,659.59 | Facility | None | $117.49 | $234.42 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $199.53 | Professional | None | $89.13 | $117.49 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,023.29 | $1,230.27 |
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 $131.83 Typical High $223.87 | Professional | None | $97.72 | $131.83 | $223.87 |
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 $39.81 Median $56.23 Typical High $75.86 | Professional | 52 · Reduced service | $39.81 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $22.39 Typical High $30.20 | Professional | 53 · Discontinued | $16.22 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $83.18 Typical High $114.82 | Professional | 54 · Surgery only | $60.26 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.60 Typical High $22.91 | Professional | 55 · Aftercare only | $12.02 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.22 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.94 | $11.22 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $77.62 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $56.23 | $77.62 | $107.15 |
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
$174
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.