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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $630.96 | Professional | None | $269.15 | $416.87 | $630.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $691.83 | Professional | None | $275.42 | $416.87 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $616.60 Typical High $2,691.53 | Facility | None | $457.09 | $616.60 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $562.34 | Professional | None | $281.84 | $398.11 | $562.34 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,466.84 | Professional | None | $3,388.44 | $3,388.44 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $691.83 | Professional | None | $263.03 | $380.19 | $691.83 |
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 $131.83 Median $208.93 Typical High $316.23 | Professional | 52 · Reduced service | $131.83 | $208.93 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $83.18 Typical High $125.89 | Professional | 53 · Discontinued | $53.70 | $83.18 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $309.03 Typical High $467.74 | Professional | 54 · Surgery only | $199.53 | $309.03 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $63.10 Typical High $95.50 | Professional | 55 · Aftercare only | $39.81 | $63.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $41.69 Typical High $63.10 | Professional | 56 · Pre-op care only | $26.92 | $41.69 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $288.40 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $186.21 | $288.40 | $436.52 |
Where Tennessee sits
The same service costs 4.3 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· 33rd of 51
$427
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.