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 $158.49 Median $234.42 Typical High $354.81 | Professional | None | $158.49 | $234.42 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $416.87 | Professional | None | $173.78 | $257.04 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $1,659.59 | Facility | None | $331.13 | $426.58 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $354.81 | Professional | None | $165.96 | $239.88 | $354.81 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,238.72 | $2,398.83 | $2,398.83 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $416.87 | Professional | None | $165.96 | $239.88 | $416.87 |
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 $79.43 Median $117.49 Typical High $177.83 | Professional | 52 · Reduced service | $79.43 | $117.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $46.77 Typical High $70.79 | Professional | 53 · Discontinued | $31.62 | $46.77 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $177.83 Typical High $269.15 | Professional | 54 · Surgery only | $120.23 | $177.83 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $35.48 Typical High $53.70 | Professional | 55 · Aftercare only | $23.99 | $35.48 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $23.44 Typical High $35.48 | Professional | 56 · Pre-op care only | $15.85 | $23.44 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $165.96 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $112.20 | $165.96 | $251.19 |
Where Tennessee sits
The same service costs 4.2 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· 31st of 51
$257
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.