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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $3,467.37 | Professional | None | $2,398.83 | $2,630.27 | $3,467.37 |
BCBS Tennessee Setting Facility Modifier None Typical Low $2,398.83 Median $6,309.57 Typical High $12,022.64 | Facility | None | $2,398.83 | $6,309.57 | $12,022.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $2,754.23 Median $3,981.07 Typical High $6,456.54 | Professional | None | $2,754.23 | $3,981.07 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $14,791.08 Typical High $30,199.52 | Facility | None | $602.56 | $14,791.08 | $30,199.52 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $4,466.84 | Professional | None | $2,511.89 | $3,311.31 | $4,466.84 |
Lucent Health Setting Professional Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Professional | None | $21,379.62 | $21,379.62 | $21,379.62 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $10,000.00 Typical High $15,848.93 | Facility | None | $3,630.78 | $10,000.00 | $15,848.93 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $5,623.41 | Professional | None | $2,187.76 | $2,951.21 | $5,623.41 |
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 $1,202.26 Median $1,258.93 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,202.26 | $1,258.93 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $501.19 Typical High $691.83 | Professional | 53 · Discontinued | $478.63 | $501.19 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,905.46 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,819.70 | $1,905.46 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $380.19 Typical High $512.86 | Professional | 55 · Aftercare only | $363.08 | $380.19 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $251.19 Typical High $346.74 | Professional | 56 · Pre-op care only | $239.88 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,778.28 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,778.28 | $2,398.83 |
Where Tennessee sits
The same service costs 20.0 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· 18th of 51
$3,981
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.