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 $2,344.23 Median $4,570.88 Typical High $10,715.19 | Facility | None | $2,344.23 | $4,570.88 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,202.26 | Professional | None | $776.25 | $1,023.29 | $1,202.26 |
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 $977.24 Median $1,288.25 Typical High $2,089.30 | Professional | None | $977.24 | $1,288.25 | $2,089.30 |
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 $851.14 Median $1,023.29 Typical High $1,905.46 | Professional | None | $851.14 | $1,023.29 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,918.31 | Professional | None | $6,606.93 | $6,606.93 | $6,918.31 |
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 $851.14 Median $1,230.27 Typical High $1,949.84 | Professional | None | $851.14 | $1,230.27 | $1,949.84 |
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 $389.05 Median $512.86 Typical High $602.56 | Professional | 52 · Reduced service | $389.05 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $204.17 Typical High $245.47 | Professional | 53 · Discontinued | $154.88 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $776.25 Typical High $912.01 | Professional | 54 · Surgery only | $588.84 | $776.25 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $154.88 Typical High $181.97 | Professional | 55 · Aftercare only | $117.49 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $102.33 Typical High $120.23 | Professional | 56 · Pre-op care only | $77.62 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $724.44 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $549.54 | $724.44 | $851.14 |
Where Tennessee sits
The same service costs 6.3 times more in Alaska 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· 17th of 51
$1,349
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.