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 $524.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $524.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $446.68 | Professional | None | $257.04 | $309.03 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | None | $316.23 | $316.23 | $323.59 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,513.56 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $602.56 | Professional | None | $269.15 | $323.59 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,818.38 Typical High $6,606.93 | Facility | None | $602.56 | $2,818.38 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $467.74 | Professional | None | $269.15 | $275.42 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,818.38 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,248.07 | Facility | None | $1,000.00 | $2,570.40 | $5,248.07 |
United Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $602.56 | Professional | None | $251.19 | $316.23 | $602.56 |
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 $128.82 Median $141.25 Typical High $194.98 | Professional | 52 · Reduced service | $128.82 | $141.25 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $56.23 Typical High $77.62 | Professional | 53 · Discontinued | $52.48 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $295.12 | Professional | 54 · Surgery only | $194.98 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $58.88 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.18 Typical High $38.90 | Professional | 56 · Pre-op care only | $25.70 | $28.18 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $275.42 |
Where Tennessee sits
The same service costs 5.5 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· 25th of 51
$389
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.