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 $1,621.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,621.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $912.01 | Professional | None | $524.81 | $616.60 | $912.01 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,258.93 Typical High $2,818.38 | Facility | None | $575.44 | $1,258.93 | $2,818.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $1,412.54 | Professional | None | $616.60 | $891.25 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,096.48 Typical High $2,691.53 | Facility | None | $602.56 | $1,096.48 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,071.52 | Professional | None | $549.54 | $691.83 | $1,071.52 |
Lucent Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,011.87 | $5,495.41 | $5,495.41 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,258.93 | Professional | None | $489.78 | $691.83 | $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 $263.03 Median $281.84 Typical High $389.05 | Professional | 52 · Reduced service | $263.03 | $281.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $154.88 | Professional | 53 · Discontinued | $104.71 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $575.44 | Professional | 54 · Surgery only | $389.05 | $416.87 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $83.18 Typical High $114.82 | Professional | 55 · Aftercare only | $77.62 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $77.62 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $537.03 |
Where Tennessee sits
The same service costs 7.4 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· 17th of 51
$1,000
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.