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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $575.44 | Professional | None | $275.42 | $398.11 | $575.44 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $346.74 Median $575.44 Typical High $1,071.52 | Professional | None | $346.74 | $575.44 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $588.84 Typical High $2,691.53 | Facility | None | $316.23 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $707.95 | Professional | None | $288.40 | $416.87 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,801.89 | Professional | None | $3,235.94 | $3,235.94 | $3,801.89 |
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 $281.84 Median $436.52 Typical High $794.33 | Professional | None | $281.84 | $436.52 | $794.33 |
7 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 $134.90 Median $199.53 Typical High $288.40 | Professional | 52 · Reduced service | $134.90 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $81.28 Typical High $114.82 | Professional | 53 · Discontinued | $54.95 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $302.00 Typical High $436.52 | Professional | 54 · Surgery only | $204.17 | $302.00 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $60.26 Typical High $87.10 | Professional | 55 · Aftercare only | $40.74 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $39.81 Typical High $57.54 | Professional | 56 · Pre-op care only | $27.54 | $39.81 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $281.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $190.55 | $281.84 | $407.38 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 79 · Unrelated procedure after surgery | $398.11 | $398.11 | $398.11 |
Where Tennessee sits
The same service costs 4.5 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· 16th of 51
$550
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.