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 $1,479.11 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,479.11 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $602.56 | Professional | None | $389.05 | $512.86 | $602.56 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,047.13 | Professional | None | $467.74 | $616.60 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,041.74 Typical High $3,801.89 | Facility | None | $524.81 | $2,041.74 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $933.25 | Professional | None | $426.58 | $512.86 | $933.25 |
Lucent Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,548.13 | Professional | None | $3,311.31 | $3,311.31 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $954.99 | Professional | None | $416.87 | $588.84 | $954.99 |
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 $194.98 Median $257.04 Typical High $302.00 | Professional | 52 · Reduced service | $194.98 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $77.62 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $288.40 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $57.54 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $38.90 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $269.15 | $354.81 | $416.87 |
Where Tennessee sits
The same service costs 8.9 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· 5th of 51
$1,259
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.