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 $275.42 Median $2,290.87 Typical High $6,606.93 | Facility | None | $275.42 | $2,290.87 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $407.38 | Professional | None | $204.17 | $275.42 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $512.86 | Professional | None | $218.78 | $309.03 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $831.76 Typical High $2,187.76 | Facility | None | $524.81 | $831.76 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $426.58 | Professional | None | $208.93 | $281.84 | $426.58 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,630.27 | Professional | None | $2,187.76 | $2,187.76 | $2,630.27 |
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 $213.80 Median $288.40 Typical High $524.81 | Professional | None | $213.80 | $288.40 | $524.81 |
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 $102.33 Median $138.04 Typical High $204.17 | Professional | 52 · Reduced service | $102.33 | $138.04 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $54.95 Typical High $83.18 | Professional | 53 · Discontinued | $40.74 | $54.95 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $204.17 Typical High $309.03 | Professional | 54 · Surgery only | $151.36 | $204.17 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $41.69 Typical High $61.66 | Professional | 55 · Aftercare only | $30.20 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $27.54 Typical High $40.74 | Professional | 56 · Pre-op care only | $20.42 | $27.54 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $190.55 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $141.25 | $190.55 | $288.40 |
Where Tennessee sits
The same service costs 4.3 times more in Alaska than in Utah. 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
$316
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.