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 $1,479.11 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,479.11 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $1,819.70 | Professional | None | $501.19 | $549.54 | $1,819.70 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,174.90 Median $2,290.87 Typical High $5,248.07 | Facility | None | $1,174.90 | $2,290.87 | $5,248.07 |
BCBS Tennessee Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,000.00 | Professional | None | $575.44 | $676.08 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $2,754.23 | Facility | None | $588.84 | $1,548.82 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $1,000.00 | Professional | None | $512.86 | $562.34 | $1,000.00 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,128.61 | Professional | None | $4,677.35 | $4,677.35 | $5,128.61 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,096.48 | Professional | None | $537.03 | $660.69 | $1,096.48 |
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 $251.19 Median $257.04 Typical High $354.81 | Professional | 52 · Reduced service | $251.19 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $141.25 | Professional | 53 · Discontinued | $100.00 | $102.33 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $524.81 | Professional | 54 · Surgery only | $371.54 | $389.05 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $104.71 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $51.29 Typical High $70.79 | Professional | 56 · Pre-op care only | $50.12 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $489.78 |
Where Tennessee sits
The same service costs 7.2 times more in Alaska than in Texas. 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· 7th of 51
$1,349
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.