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 $363.08 Median $398.11 Typical High $645.65 | Professional | None | $363.08 | $398.11 | $645.65 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,230.27 Typical High $3,235.94 | Facility | None | $501.19 | $1,230.27 | $3,235.94 |
BCBS Tennessee Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $977.24 | Professional | None | $457.09 | $616.60 | $977.24 |
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 $416.87 Median $524.81 Typical High $794.33 | Professional | None | $416.87 | $524.81 | $794.33 |
Lucent Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,715.35 | Professional | None | $3,235.94 | $3,235.94 | $3,715.35 |
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 $407.38 Median $588.84 Typical High $933.25 | Professional | None | $407.38 | $588.84 | $933.25 |
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 $177.83 Median $199.53 Typical High $208.93 | Professional | 52 · Reduced service | $177.83 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $79.43 Typical High $83.18 | Professional | 53 · Discontinued | $72.44 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $302.00 Typical High $309.03 | Professional | 54 · Surgery only | $269.15 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $60.26 Typical High $61.66 | Professional | 55 · Aftercare only | $53.70 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $39.81 Typical High $41.69 | Professional | 56 · Pre-op care only | $36.31 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $281.84 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $251.19 | $281.84 | $288.40 |
Where Tennessee sits
The same service costs 7.2 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· 12th of 51
$794
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.