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 $1,862.09 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,862.09 | $1,995.26 | $3,090.30 |
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 $2,187.76 Median $2,754.23 Typical High $4,570.88 | Professional | None | $2,187.76 | $2,754.23 | $4,570.88 |
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 $1,737.80 Median $2,630.27 Typical High $3,801.89 | Professional | None | $1,737.80 | $2,630.27 | $3,801.89 |
Lucent Health Setting Professional Modifier None Typical Low $25,703.96 Median $25,703.96 Typical High $25,703.96 | Professional | None | $25,703.96 | $25,703.96 | $25,703.96 |
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 $1,862.09 Median $2,951.21 Typical High $4,466.84 | Professional | None | $1,862.09 | $2,951.21 | $4,466.84 |
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 $933.25 Median $1,000.00 Typical High $1,548.82 | Professional | 52 · Reduced service | $933.25 | $1,000.00 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $398.11 Typical High $630.96 | Professional | 53 · Discontinued | $371.54 | $398.11 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,479.11 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,412.54 | $1,479.11 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $295.12 Typical High $467.74 | Professional | 55 · Aftercare only | $281.84 | $295.12 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $199.53 Typical High $309.03 | Professional | 56 · Pre-op care only | $186.21 | $199.53 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,380.38 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,380.38 | $2,187.76 |
Where Tennessee sits
The same service costs 6.0 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· 35th of 51
$2,291
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.