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 $181.97 Median $288.40 Typical High $436.52 | Professional | None | $181.97 | $288.40 | $436.52 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $467.74 | Professional | None | $181.97 | $275.42 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $416.87 Typical High $1,659.59 | Facility | None | $302.00 | $416.87 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $389.05 | Professional | None | $177.83 | $263.03 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,754.23 | Professional | None | $2,187.76 | $2,187.76 | $2,754.23 |
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 $239.88 Typical High $446.68 | Professional | None | $162.18 | $239.88 | $446.68 |
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 $91.20 Median $141.25 Typical High $218.78 | Professional | 52 · Reduced service | $91.20 | $141.25 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $56.23 Typical High $87.10 | Professional | 53 · Discontinued | $36.31 | $56.23 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $213.80 Typical High $331.13 | Professional | 54 · Surgery only | $138.04 | $213.80 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $66.07 | Professional | 55 · Aftercare only | $27.54 | $42.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $28.18 Typical High $43.65 | Professional | 56 · Pre-op care only | $18.20 | $28.18 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $199.53 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $128.82 | $199.53 | $309.03 |
Where Tennessee sits
The same service costs 4.5 times more in Alaska 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· 27th of 51
$288
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.