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 $1,621.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,621.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,047.13 | Professional | None | $691.83 | $724.44 | $1,047.13 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,570.40 Typical High $6,309.57 | Facility | None | $1,071.52 | $2,570.40 | $6,309.57 |
BCBS Tennessee Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Professional | None | $758.58 | $1,023.29 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,818.38 Typical High $5,888.44 | Facility | None | $602.56 | $2,818.38 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,445.44 | Professional | None | $660.69 | $831.76 | $1,445.44 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,709.64 | Facility | None | $1,548.82 | $4,570.88 | $8,709.64 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,584.89 | Professional | None | $676.08 | $1,000.00 | $1,584.89 |
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 $346.74 Median $363.08 Typical High $524.81 | Professional | 52 · Reduced service | $346.74 | $363.08 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $208.93 | Professional | 53 · Discontinued | $138.04 | $144.54 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $537.03 Typical High $776.25 | Professional | 54 · Surgery only | $524.81 | $537.03 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $107.15 Typical High $154.88 | Professional | 55 · Aftercare only | $104.71 | $107.15 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $104.71 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $501.19 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $489.78 | $501.19 | $724.44 |
Where Tennessee sits
The same service costs 8.7 times more in Oklahoma 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· 9th of 51
$1,622
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.