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 $309.03 Median $2,290.87 Typical High $6,606.93 | Facility | None | $309.03 | $2,290.87 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $467.74 | Professional | None | $169.82 | $302.00 | $467.74 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $549.54 | Professional | None | $223.87 | $346.74 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $501.19 Typical High $2,187.76 | Facility | None | $251.19 | $501.19 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $616.60 | Professional | None | $234.42 | $363.08 | $616.60 |
Lucent Health Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,754.23 | $2,754.23 | $3,388.44 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $575.44 | Professional | None | $208.93 | $346.74 | $575.44 |
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 $85.11 Median $131.83 Typical High $204.17 | Professional | 52 · Reduced service | $85.11 | $131.83 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $52.48 Typical High $81.28 | Professional | 53 · Discontinued | $33.88 | $52.48 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $199.53 Typical High $309.03 | Professional | 54 · Surgery only | $125.89 | $199.53 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $39.81 Typical High $61.66 | Professional | 55 · Aftercare only | $25.12 | $39.81 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $26.30 Typical High $40.74 | Professional | 56 · Pre-op care only | $16.98 | $26.30 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $186.21 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $117.49 | $186.21 | $288.40 |
Where Tennessee sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 17th of 51
$407
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.