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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $213.80 | Professional | None | $95.50 | $138.04 | $213.80 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,122.02 Median $2,238.72 Typical High $5,248.07 | Facility | None | $1,122.02 | $2,238.72 | $5,248.07 |
BCBS Tennessee Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $316.23 | Professional | None | $131.83 | $173.78 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $204.17 Typical High $2,691.53 | Facility | None | $102.33 | $204.17 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $288.40 | Professional | None | $104.71 | $154.88 | $288.40 |
Lucent Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,412.54 | Professional | None | $1,230.27 | $1,230.27 | $1,412.54 |
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 $109.65 Median $177.83 Typical High $302.00 | Professional | None | $109.65 | $177.83 | $302.00 |
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 $47.86 Median $67.61 Typical High $97.72 | Professional | 52 · Reduced service | $47.86 | $67.61 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $27.54 Typical High $38.90 | Professional | 53 · Discontinued | $19.05 | $27.54 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $102.33 Typical High $144.54 | Professional | 54 · Surgery only | $72.44 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $20.42 Typical High $28.84 | Professional | 55 · Aftercare only | $14.45 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.80 Typical High $19.50 | Professional | 56 · Pre-op care only | $9.55 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $95.50 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $67.61 | $95.50 | $134.90 |
Where Tennessee sits
The same service costs 3.6 times more in Wisconsin 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· 14th of 51
$219
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.