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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $741.31 | Professional | None | $467.74 | $588.84 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,148.15 | Professional | None | $478.63 | $616.60 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $436.52 Typical High $1,659.59 | Facility | None | $338.84 | $436.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $1,000.00 | Professional | None | $389.05 | $457.09 | $1,000.00 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $5,623.41 Typical High $5,623.41 | Professional | None | $4,786.30 | $5,623.41 | $5,623.41 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,174.90 | Professional | None | $478.63 | $630.96 | $1,174.90 |
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 $234.42 Median $251.19 Typical High $371.54 | Professional | 52 · Reduced service | $234.42 | $251.19 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $102.33 Typical High $147.91 | Professional | 53 · Discontinued | $93.33 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $562.34 | Professional | 54 · Surgery only | $346.74 | $380.19 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $112.20 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $74.13 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $524.81 |
Where Tennessee sits
The same service costs 6.2 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· 32nd of 51
$692
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.