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 $1,258.93 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,348.96 | $2,089.30 |
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 $1,445.44 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,445.44 | $1,862.09 | $3,090.30 |
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 $1,174.90 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,737.80 | $2,511.89 |
Lucent Health Setting Professional Modifier None Typical Low $12,022.64 Median $12,022.64 Typical High $12,022.64 | Professional | None | $12,022.64 | $12,022.64 | $12,022.64 |
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 $1,258.93 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,258.93 | $1,905.46 | $3,019.95 |
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 $630.96 Median $660.69 Typical High $1,047.13 | Professional | 52 · Reduced service | $630.96 | $660.69 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $269.15 Typical High $416.87 | Professional | 53 · Discontinued | $251.19 | $269.15 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,584.89 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $199.53 Typical High $316.23 | Professional | 55 · Aftercare only | $190.55 | $199.53 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $134.90 Typical High $208.93 | Professional | 56 · Pre-op care only | $125.89 | $134.90 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $1,479.11 |
Where Tennessee sits
The same service costs 5.0 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· 29th of 51
$1,820
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.