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 $173.78 Median $177.83 Typical High $269.15 | Professional | None | $173.78 | $177.83 | $269.15 |
BCBS Tennessee Setting Facility Modifier None Typical Low $537.03 Median $1,148.15 Typical High $2,754.23 | Facility | None | $537.03 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $457.09 | Professional | None | $194.98 | $263.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $1,659.59 | Facility | None | $389.05 | $831.76 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $371.54 | Professional | None | $173.78 | $208.93 | $371.54 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,445.44 | Professional | None | $1,348.96 | $1,348.96 | $1,445.44 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $416.87 | Professional | None | $177.83 | $257.04 | $416.87 |
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 $85.11 Median $89.13 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $89.13 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $36.31 Typical High $53.70 | Professional | 53 · Discontinued | $34.67 | $36.31 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $134.90 Typical High $204.17 | Professional | 54 · Surgery only | $128.82 | $134.90 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $40.74 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.78 Typical High $26.92 | Professional | 56 · Pre-op care only | $17.38 | $17.78 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $125.89 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $120.23 | $125.89 | $190.55 |
Where Tennessee sits
The same service costs 8.9 times more in Oklahoma 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· 4th of 51
$661
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.