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 $1,380.38 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,380.38 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $436.52 | Professional | None | $181.97 | $288.40 | $436.52 |
BCBS Tennessee Setting Facility Modifier None Typical Low $831.76 Median $1,584.89 Typical High $3,467.37 | Facility | None | $831.76 | $1,584.89 | $3,467.37 |
BCBS Tennessee Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $467.74 | Professional | None | $204.17 | $302.00 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $537.03 Typical High $2,691.53 | Facility | None | $269.15 | $537.03 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $436.52 | Professional | None | $165.96 | $251.19 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,630.27 | $3,311.31 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $501.19 | Professional | None | $190.55 | $302.00 | $501.19 |
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 $91.20 Median $144.54 Typical High $218.78 | Professional | 52 · Reduced service | $91.20 | $144.54 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $57.54 Typical High $87.10 | Professional | 53 · Discontinued | $36.31 | $57.54 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $218.78 Typical High $323.59 | Professional | 54 · Surgery only | $138.04 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $43.65 Typical High $64.57 | Professional | 55 · Aftercare only | $27.54 | $43.65 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $28.84 Typical High $43.65 | Professional | 56 · Pre-op care only | $18.20 | $28.84 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $204.17 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $128.82 | $204.17 | $302.00 |
Where Tennessee sits
The same service costs 4.2 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· 10th of 51
$417
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.