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 $549.54 Median $616.60 Typical High $851.14 | Professional | None | $549.54 | $616.60 | $851.14 |
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 $549.54 Median $616.60 Typical High $1,174.90 | Professional | None | $549.54 | $616.60 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,089.30 Typical High $3,801.89 | Facility | None | $741.31 | $2,089.30 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $977.24 | Professional | None | $575.44 | $645.65 | $977.24 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,248.07 | Professional | None | $5,128.61 | $5,128.61 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,258.93 | Professional | None | $524.81 | $630.96 | $1,258.93 |
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 $275.42 Median $295.12 Typical High $416.87 | Professional | 52 · Reduced service | $275.42 | $295.12 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $165.96 | Professional | 53 · Discontinued | $109.65 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $616.60 | Professional | 54 · Surgery only | $407.38 | $446.68 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $123.03 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $83.18 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $575.44 |
Where Tennessee sits
The same service costs 5.9 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· 27th of 51
$794
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.