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 $331.13 Median $371.54 Typical High $512.86 | Professional | None | $331.13 | $371.54 | $512.86 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $3,630.78 | Facility | None | $501.19 | $1,318.26 | $3,630.78 |
BCBS Tennessee Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $891.25 | Professional | None | $416.87 | $562.34 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $588.84 Typical High $2,187.76 | Facility | None | $512.86 | $588.84 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $741.31 | Professional | None | $380.19 | $489.78 | $741.31 |
Lucent Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,388.44 | Professional | None | $3,019.95 | $3,019.95 | $3,388.44 |
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 $380.19 Median $537.03 Typical High $851.14 | Professional | None | $380.19 | $537.03 | $851.14 |
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 $165.96 Median $186.21 Typical High $190.55 | Professional | 52 · Reduced service | $165.96 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $75.86 | Professional | 53 · Discontinued | $66.07 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $275.42 Typical High $288.40 | Professional | 54 · Surgery only | $245.47 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $57.54 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $38.02 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $257.04 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $229.09 | $257.04 | $269.15 |
Where Tennessee sits
The same service costs 6.0 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· 11th of 51
$759
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.