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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $933.25 | Professional | None | $537.03 | $645.65 | $933.25 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,659.59 | Professional | None | $660.69 | $1,000.00 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $831.76 Typical High $2,187.76 | Facility | None | $524.81 | $831.76 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $1,148.15 | Professional | None | $537.03 | $724.44 | $1,148.15 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Professional | None | $5,128.61 | $5,128.61 | $6,165.95 |
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 $478.63 Median $676.08 Typical High $1,258.93 | Professional | None | $478.63 | $676.08 | $1,258.93 |
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 $269.15 Median $316.23 Typical High $457.09 | Professional | 52 · Reduced service | $269.15 | $316.23 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $128.82 Typical High $181.97 | Professional | 53 · Discontinued | $107.15 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $478.63 Typical High $676.08 | Professional | 54 · Surgery only | $398.11 | $478.63 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $95.50 Typical High $134.90 | Professional | 55 · Aftercare only | $79.43 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $64.57 Typical High $91.20 | Professional | 56 · Pre-op care only | $53.70 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $446.68 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $371.54 | $446.68 | $630.96 |
Where Tennessee sits
The same service costs 5.6 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· 19th of 51
$871
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.