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 $794.33 Median $954.99 Typical High $1,230.27 | Professional | None | $794.33 | $954.99 | $1,230.27 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,318.26 | Professional | None | $776.25 | $891.25 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,041.74 Typical High $3,801.89 | Facility | None | $524.81 | $2,041.74 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,230.27 | Professional | None | $630.96 | $707.95 | $1,230.27 |
Lucent Health Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,606.93 | Professional | None | $6,165.95 | $6,165.95 | $6,606.93 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,380.38 | Professional | None | $676.08 | $851.14 | $1,380.38 |
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 $398.11 Median $416.87 Typical High $588.84 | Professional | 52 · Reduced service | $398.11 | $416.87 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $239.88 | Professional | 53 · Discontinued | $158.49 | $169.82 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $630.96 Typical High $891.25 | Professional | 54 · Surgery only | $588.84 | $630.96 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $125.89 Typical High $177.83 | Professional | 55 · Aftercare only | $117.49 | $125.89 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $117.49 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $588.84 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $549.54 | $588.84 | $831.76 |
Where Tennessee sits
The same service costs 8.3 times more in Wyoming 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
$1,622
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.