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 $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,949.84 | $1,995.26 | $2,818.38 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $5,128.61 | Professional | None | $2,187.76 | $2,884.03 | $5,128.61 |
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 $1,949.84 Median $2,511.89 Typical High $4,073.80 | Professional | None | $1,949.84 | $2,511.89 | $4,073.80 |
Lucent Health Setting Professional Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $19,054.61 | Professional | None | $15,135.61 | $15,135.61 | $19,054.61 |
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 $1,995.26 Median $2,884.03 Typical High $4,677.35 | Professional | None | $1,995.26 | $2,884.03 | $4,677.35 |
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 $977.24 Median $1,000.00 Typical High $1,412.54 | Professional | 52 · Reduced service | $977.24 | $1,000.00 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $398.11 Typical High $575.44 | Professional | 53 · Discontinued | $389.05 | $398.11 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,479.11 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,445.44 | $1,479.11 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $295.12 Typical High $426.58 | Professional | 55 · Aftercare only | $288.40 | $295.12 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $199.53 Typical High $281.84 | Professional | 56 · Pre-op care only | $194.98 | $199.53 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,380.38 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,380.38 | $1,995.26 |
Where Tennessee sits
The same service costs 13.5 times more in Alaska than in Texas. 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· 34th of 51
$2,570
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.