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 $676.08 Median $794.33 Typical High $1,174.90 | Professional | None | $676.08 | $794.33 | $1,174.90 |
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 $812.83 Median $1,148.15 Typical High $1,819.70 | Professional | None | $812.83 | $1,148.15 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,981.07 Typical High $7,943.28 | Facility | None | $602.56 | $3,981.07 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,348.96 | Professional | None | $707.95 | $912.01 | $1,348.96 |
Lucent Health Setting Professional Modifier None Typical Low $6,309.57 Median $6,760.83 Typical High $6,760.83 | Professional | None | $6,309.57 | $6,760.83 | $6,760.83 |
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 $645.65 Median $891.25 Typical High $1,621.81 | Professional | None | $645.65 | $891.25 | $1,621.81 |
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 $338.84 Median $363.08 Typical High $501.19 | Professional | 52 · Reduced service | $338.84 | $363.08 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $199.53 | Professional | 53 · Discontinued | $134.90 | $144.54 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $537.03 Typical High $741.31 | Professional | 54 · Surgery only | $512.86 | $537.03 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $107.15 Typical High $151.36 | Professional | 55 · Aftercare only | $102.33 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $100.00 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $501.19 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $478.63 | $501.19 | $691.83 |
Where Tennessee sits
The same service costs 7.6 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· 8th of 51
$1,549
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.