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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $338.84 | Professional | None | $173.78 | $239.88 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $426.58 | Professional | None | $218.78 | $295.12 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $912.01 Typical High $1,659.59 | Facility | None | $389.05 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $407.38 | Professional | None | $186.21 | $245.47 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,454.71 | Professional | None | $2,041.74 | $2,041.74 | $2,454.71 |
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 $213.80 Median $275.42 Typical High $467.74 | Professional | None | $213.80 | $275.42 | $467.74 |
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 $87.10 Median $114.82 Typical High $151.36 | Professional | 52 · Reduced service | $87.10 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $45.71 Typical High $60.26 | Professional | 53 · Discontinued | $34.67 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $173.78 Typical High $229.09 | Professional | 54 · Surgery only | $131.83 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $34.67 Typical High $45.71 | Professional | 55 · Aftercare only | $26.30 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.91 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.38 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $162.18 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $123.03 | $162.18 | $213.80 |
Where Tennessee sits
The same service costs 3.9 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· 12th of 51
$389
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.