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 $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,174.90 | Professional | None | $851.14 | $954.99 | $1,174.90 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,445.44 Typical High $3,715.35 | Facility | None | $501.19 | $1,445.44 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $2,137.96 | Professional | None | $933.25 | $1,258.93 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,778.28 | Professional | None | $812.83 | $1,023.29 | $1,778.28 |
Lucent Health Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,760.83 | Professional | None | $6,606.93 | $6,606.93 | $6,760.83 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,995.26 | Professional | None | $831.76 | $1,202.26 | $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 $426.58 Median $478.63 Typical High $588.84 | Professional | 52 · Reduced service | $426.58 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $190.55 Typical High $234.42 | Professional | 53 · Discontinued | $169.82 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $724.44 Typical High $891.25 | Professional | 54 · Surgery only | $630.96 | $724.44 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $177.83 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $95.50 Typical High $117.49 | Professional | 56 · Pre-op care only | $85.11 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $676.08 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $588.84 | $676.08 | $831.76 |
Where Tennessee sits
The same service costs 5.6 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· 16th of 51
$1,288
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.