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 $3,090.30 Typical High $7,585.78 | Facility | None | $2,454.71 | $3,090.30 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,348.96 | Professional | None | $870.96 | $933.25 | $1,348.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $5,128.61 | Facility | None | $1,122.02 | $2,137.96 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,905.46 | Professional | None | $870.96 | $1,023.29 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,862.09 Typical High $3,801.89 | Facility | None | $831.76 | $1,862.09 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,513.56 | Professional | None | $851.14 | $891.25 | $1,513.56 |
Lucent Health Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Professional | None | $9,332.54 | $9,332.54 | $9,332.54 |
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 $851.14 Median $1,023.29 Typical High $1,995.26 | Professional | None | $851.14 | $1,023.29 | $1,995.26 |
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 $436.52 Median $467.74 Typical High $660.69 | Professional | 52 · Reduced service | $436.52 | $467.74 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $263.03 | Professional | 53 · Discontinued | $173.78 | $186.21 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $1,000.00 | Professional | 54 · Surgery only | $660.69 | $707.95 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $199.53 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $131.83 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $933.25 |
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· 30th of 51
$1,122
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.