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 $3,090.30 Typical High $7,585.78 | Facility | None | $2,454.71 | $3,090.30 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,621.81 | Professional | None | $933.25 | $1,096.48 | $1,621.81 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $10,471.29 | Facility | None | $1,621.81 | $4,897.79 | $10,471.29 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,584.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $10,000.00 Typical High $20,892.96 | Facility | None | $831.76 | $10,000.00 | $20,892.96 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,778.28 | Professional | None | $977.24 | $1,258.93 | $1,778.28 |
Lucent Health Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $8,511.38 | Professional | None | $7,762.47 | $7,762.47 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $2,187.76 | Professional | None | $891.25 | $1,174.90 | $2,187.76 |
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 $467.74 Median $489.78 Typical High $676.08 | Professional | 52 · Reduced service | $467.74 | $489.78 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $269.15 | Professional | 53 · Discontinued | $186.21 | $199.53 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $1,023.29 | Professional | 54 · Surgery only | $691.83 | $741.31 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $204.17 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $134.90 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $954.99 |
Where Tennessee sits
The same service costs 7.9 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· 8th of 51
$2,042
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.