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 $2,454.71 Median $3,981.07 Typical High $7,585.78 | Facility | None | $2,454.71 | $3,981.07 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,000.00 | Professional | None | $630.96 | $831.76 | $1,000.00 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,513.56 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,778.28 | Professional | None | $776.25 | $1,047.13 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,630.78 Typical High $6,606.93 | Facility | None | $831.76 | $3,630.78 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,548.82 | Professional | None | $676.08 | $812.83 | $1,548.82 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,548.82 | Professional | None | $691.83 | $1,023.29 | $1,548.82 |
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 $309.03 Median $416.87 Typical High $489.78 | Professional | 52 · Reduced service | $309.03 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $165.96 Typical High $194.98 | Professional | 53 · Discontinued | $125.89 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $616.60 Typical High $724.44 | Professional | 54 · Surgery only | $467.74 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $93.33 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $63.10 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $575.44 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $436.52 | $575.44 | $676.08 |
Where Tennessee sits
The same service costs 6.5 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· 7th of 51
$1,862
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.