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 $467.74 Median $549.54 Typical High $831.76 | Professional | None | $467.74 | $549.54 | $831.76 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,089.30 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,288.25 | Professional | None | $549.54 | $794.33 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $3,630.78 | Facility | None | $602.56 | $1,995.26 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $891.25 | Professional | None | $501.19 | $630.96 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,570.88 | Professional | None | $3,981.07 | $3,981.07 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $1,122.02 | Professional | None | $436.52 | $575.44 | $1,122.02 |
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 $234.42 Median $251.19 Typical High $338.84 | Professional | 52 · Reduced service | $234.42 | $251.19 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $134.90 | Professional | 53 · Discontinued | $95.50 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $380.19 Typical High $512.86 | Professional | 54 · Surgery only | $354.81 | $380.19 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $102.33 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $67.61 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $354.81 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $331.13 | $354.81 | $478.63 |
Where Tennessee sits
The same service costs 7.9 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· 10th of 51
$1,072
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.