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 $309.03 Median $524.81 Typical High $758.58 | Professional | None | $309.03 | $524.81 | $758.58 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $371.54 Median $676.08 Typical High $1,380.38 | Professional | None | $371.54 | $676.08 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,412.54 Typical High $2,570.40 | Facility | None | $524.81 | $1,412.54 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $851.14 | Professional | None | $331.13 | $537.03 | $851.14 |
Lucent Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $5,495.41 | Professional | None | $4,168.69 | $4,168.69 | $5,495.41 |
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 $309.03 Median $524.81 Typical High $977.24 | Professional | None | $309.03 | $524.81 | $977.24 |
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 $154.88 Median $263.03 Typical High $371.54 | Professional | 52 · Reduced service | $154.88 | $263.03 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $104.71 Typical High $151.36 | Professional | 53 · Discontinued | $61.66 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $389.05 Typical High $562.34 | Professional | 54 · Surgery only | $229.09 | $389.05 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $77.62 Typical High $112.20 | Professional | 55 · Aftercare only | $46.77 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $52.48 Typical High $75.86 | Professional | 56 · Pre-op care only | $30.90 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $363.08 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $213.80 | $363.08 | $524.81 |
Where Tennessee sits
The same service costs 4.7 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
$676
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.