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 $1,288.25 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,445.44 | $2,238.72 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $8,317.64 | Facility | None | $1,288.25 | $3,388.44 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,479.11 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,479.11 | $2,187.76 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,801.89 Typical High $7,943.28 | Facility | None | $602.56 | $3,801.89 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,737.80 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $11,481.54 | Professional | None | $10,471.29 | $10,471.29 | $11,481.54 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,230.27 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $3,019.95 | Professional | None | $1,071.52 | $1,445.44 | $3,019.95 |
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 $645.65 Median $676.08 Typical High $933.25 | Professional | 52 · Reduced service | $645.65 | $676.08 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $371.54 | Professional | 53 · Discontinued | $257.04 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,023.29 Typical High $1,380.38 | Professional | 54 · Surgery only | $954.99 | $1,023.29 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $204.17 Typical High $275.42 | Professional | 55 · Aftercare only | $194.98 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $186.21 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $954.99 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $891.25 | $954.99 | $1,288.25 |
Where Tennessee sits
The same service costs 8.9 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· 13th of 51
$2,291
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.