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 $131.83 Median $169.82 Typical High $234.42 | Professional | None | $131.83 | $169.82 | $234.42 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $416.87 | Professional | None | $165.96 | $245.47 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $162.18 Typical High $302.00 | Facility | None | $50.12 | $162.18 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $295.12 | Professional | None | $141.25 | $194.98 | $295.12 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $331.13 | Professional | None | $131.83 | $177.83 | $331.13 |
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 $66.07 Median $79.43 Typical High $112.20 | Professional | 52 · Reduced service | $66.07 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $31.62 Typical High $44.67 | Professional | 53 · Discontinued | $26.30 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $117.49 Typical High $169.82 | Professional | 54 · Surgery only | $97.72 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.99 Typical High $33.88 | Professional | 55 · Aftercare only | $19.95 | $23.99 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $15.85 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.18 | $15.85 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $109.65 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $91.20 | $109.65 | $158.49 |
Where Tennessee sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 21st of 51
$224
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.