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 $588.84 Median $676.08 Typical High $1,047.13 | Professional | None | $588.84 | $676.08 | $1,047.13 |
BCBS Tennessee Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $5,128.61 | Facility | None | $933.25 | $1,905.46 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,584.89 | Professional | None | $645.65 | $933.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,698.24 Typical High $3,548.13 | Facility | None | $389.05 | $1,698.24 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,096.48 | Professional | None | $616.60 | $724.44 | $1,096.48 |
Lucent Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $5,888.44 | Professional | None | $4,897.79 | $4,897.79 | $5,888.44 |
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 $537.03 Median $707.95 Typical High $1,348.96 | Professional | None | $537.03 | $707.95 | $1,348.96 |
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 $295.12 Median $316.23 Typical High $426.58 | Professional | 52 · Reduced service | $295.12 | $316.23 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $169.82 | Professional | 53 · Discontinued | $117.49 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $478.63 Typical High $645.65 | Professional | 54 · Surgery only | $446.68 | $478.63 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $95.50 Typical High $128.82 | Professional | 55 · Aftercare only | $89.13 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $85.11 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $446.68 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $416.87 | $446.68 | $602.56 |
Where Tennessee sits
The same service costs 7.8 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
$1,096
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.