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 $2,344.23 Median $4,570.88 Typical High $10,715.19 | Facility | None | $2,344.23 | $4,570.88 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,412.54 | $1,584.89 | $2,238.72 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,513.56 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $3,630.78 | Professional | None | $1,513.56 | $2,041.74 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $3,715.35 Typical High $6,760.83 | Facility | None | $1,479.11 | $3,715.35 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,659.59 | $2,951.21 |
Lucent Health Setting Professional Modifier None Typical Low $12,022.64 Median $12,022.64 Typical High $12,589.25 | Professional | None | $12,022.64 | $12,022.64 | $12,589.25 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $3,467.37 | Professional | None | $1,445.44 | $2,041.74 | $3,467.37 |
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 $707.95 Median $741.31 Typical High $1,122.02 | Professional | 52 · Reduced service | $707.95 | $741.31 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $295.12 Typical High $446.68 | Professional | 53 · Discontinued | $281.84 | $295.12 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,096.48 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,071.52 | $1,096.48 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $223.87 Typical High $331.13 | Professional | 55 · Aftercare only | $213.80 | $223.87 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $147.91 Typical High $223.87 | Professional | 56 · Pre-op care only | $141.25 | $147.91 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,023.29 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,023.29 | $1,548.82 |
Where Tennessee sits
The same service costs 6.3 times more in Alaska than in Utah. 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· 15th of 51
$2,884
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.