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 $144.54 Median $229.09 Typical High $331.13 | Professional | None | $144.54 | $229.09 | $331.13 |
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 $186.21 Median $323.59 Typical High $602.56 | Professional | None | $186.21 | $323.59 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $389.05 Typical High $1,659.59 | Facility | None | $204.17 | $389.05 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $389.05 | Professional | None | $151.36 | $234.42 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,862.09 | $1,862.09 | $2,238.72 |
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 $151.36 Median $239.88 Typical High $446.68 | Professional | None | $151.36 | $239.88 | $446.68 |
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 $72.44 Median $114.82 Typical High $165.96 | Professional | 52 · Reduced service | $72.44 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $45.71 Typical High $66.07 | Professional | 53 · Discontinued | $28.84 | $45.71 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $173.78 Typical High $251.19 | Professional | 54 · Surgery only | $109.65 | $173.78 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $34.67 Typical High $50.12 | Professional | 55 · Aftercare only | $21.88 | $34.67 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $22.91 Typical High $33.11 | Professional | 56 · Pre-op care only | $14.45 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $162.18 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $102.33 | $162.18 | $234.42 |
Where Tennessee sits
The same service costs 3.7 times more in Alaska than in Utah. 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· 11th of 51
$316
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.