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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $380.19 | Professional | None | $245.47 | $323.59 | $380.19 |
BCBS Tennessee Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $5,128.61 | Facility | None | $933.25 | $1,905.46 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $660.69 | Professional | None | $302.00 | $398.11 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,089.30 Typical High $3,801.89 | Facility | None | $588.84 | $2,089.30 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $602.56 | Professional | None | $269.15 | $323.59 | $602.56 |
Lucent Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,187.76 | Professional | None | $2,089.30 | $2,089.30 | $2,187.76 |
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 $263.03 Median $380.19 Typical High $602.56 | Professional | None | $263.03 | $380.19 | $602.56 |
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 $123.03 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $123.03 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $64.57 Typical High $75.86 | Professional | 53 · Discontinued | $48.98 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $245.47 Typical High $288.40 | Professional | 54 · Surgery only | $181.97 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $48.98 Typical High $57.54 | Professional | 55 · Aftercare only | $36.31 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $32.36 Typical High $38.02 | Professional | 56 · Pre-op care only | $24.55 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $229.09 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $169.82 | $229.09 | $269.15 |
Where Tennessee sits
The same service costs 6.0 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· 3rd of 51
$1,148
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.