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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,698.24 | $1,778.28 | $2,818.38 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $4,073.80 | Professional | None | $1,905.46 | $2,454.71 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $3,388.44 | Professional | None | $1,548.82 | $2,344.23 | $3,388.44 |
Lucent Health Setting Professional Modifier None Typical Low $18,197.01 Median $18,620.87 Typical High $18,620.87 | Professional | None | $18,197.01 | $18,620.87 | $18,620.87 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,630.27 Typical High $4,073.80 | Professional | None | $1,659.59 | $2,630.27 | $4,073.80 |
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 $831.76 Median $891.25 Typical High $1,412.54 | Professional | 52 · Reduced service | $831.76 | $891.25 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $354.81 Typical High $562.34 | Professional | 53 · Discontinued | $338.84 | $354.81 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,318.26 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,258.93 | $1,318.26 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $269.15 Typical High $416.87 | Professional | 55 · Aftercare only | $251.19 | $269.15 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $177.83 Typical High $281.84 | Professional | 56 · Pre-op care only | $169.82 | $177.83 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,230.27 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,230.27 | $1,949.84 |
Where Tennessee sits
The same service costs 5.5 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· 32nd of 51
$2,239
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.