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 $2,187.76 Median $2,290.87 Typical High $3,630.78 | Professional | None | $2,187.76 | $2,290.87 | $3,630.78 |
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 $2,511.89 Median $3,235.94 Typical High $5,370.32 | Professional | None | $2,511.89 | $3,235.94 | $5,370.32 |
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 $2,041.74 Median $3,019.95 Typical High $4,365.16 | Professional | None | $2,041.74 | $3,019.95 | $4,365.16 |
Lucent Health Setting Professional Modifier None Typical Low $23,442.29 Median $23,442.29 Typical High $23,442.29 | Professional | None | $23,442.29 | $23,442.29 | $23,442.29 |
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 $2,137.96 Median $3,388.44 Typical High $5,248.07 | Professional | None | $2,137.96 | $3,388.44 | $5,248.07 |
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 $1,096.48 Median $1,148.15 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,096.48 | $1,148.15 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $457.09 Typical High $724.44 | Professional | 53 · Discontinued | $436.52 | $457.09 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,737.80 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,621.81 | $1,737.80 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $346.74 Typical High $549.54 | Professional | 55 · Aftercare only | $323.59 | $346.74 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $229.09 Typical High $363.08 | Professional | 56 · Pre-op care only | $218.78 | $229.09 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,621.81 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,621.81 | $2,511.89 |
Where Tennessee sits
The same service costs 6.2 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· 38th of 51
$2,512
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.