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 $151.36 Median $239.88 Typical High $363.08 | Professional | None | $151.36 | $239.88 | $363.08 |
BCBS Tennessee Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $5,128.61 | Facility | None | $933.25 | $1,905.46 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $562.34 | Professional | None | $194.98 | $295.12 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,659.59 | Facility | None | $229.09 | $398.11 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $457.09 | Professional | None | $151.36 | $234.42 | $457.09 |
Lucent Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,819.70 | $2,187.76 |
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 $162.18 Median $275.42 Typical High $537.03 | Professional | None | $162.18 | $275.42 | $537.03 |
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 $75.86 Median $120.23 Typical High $181.97 | Professional | 52 · Reduced service | $75.86 | $120.23 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $47.86 Typical High $72.44 | Professional | 53 · Discontinued | $30.90 | $47.86 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $181.97 Typical High $275.42 | Professional | 54 · Surgery only | $114.82 | $181.97 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $36.31 Typical High $54.95 | Professional | 55 · Aftercare only | $22.91 | $36.31 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $23.99 Typical High $36.31 | Professional | 56 · Pre-op care only | $15.14 | $23.99 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $169.82 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $107.15 | $169.82 | $257.04 |
Where Tennessee sits
The same service costs 4.3 times more in Wisconsin than in Kentucky. 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· 12th of 51
$380
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.