How much rates vary
Facilitymedian $1,995 · 10th to 90th $871 to $4,786Professionalmedian $257 · 10th to 90th $166 to $1,862
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 $812.83 Median $2,398.83 Typical High $7,585.78 | Facility | None | $812.83 | $2,398.83 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $323.59 | Professional | None | $138.04 | $204.17 | $323.59 |
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 $173.78 Median $251.19 Typical High $371.54 | Professional | None | $173.78 | $251.19 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,479.11 Typical High $2,691.53 | Facility | None | $524.81 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $416.87 | Professional | None | $186.21 | $263.03 | $416.87 |
Lucent Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,862.09 | $1,862.09 | $2,511.89 |
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 $165.96 Median $239.88 Typical High $398.11 | Professional | None | $165.96 | $239.88 | $398.11 |
7 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 $67.61 Median $102.33 Typical High $138.04 | Professional | 52 · Reduced service | $67.61 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $40.74 Typical High $54.95 | Professional | 53 · Discontinued | $27.54 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $151.36 Typical High $208.93 | Professional | 54 · Surgery only | $102.33 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $30.20 Typical High $41.69 | Professional | 55 · Aftercare only | $20.42 | $30.20 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $20.42 Typical High $27.54 | Professional | 56 · Pre-op care only | $13.80 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $141.25 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $95.50 | $141.25 | $194.98 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $288.40 |
Where Tennessee sits
The same service costs 9.3 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $5,912MT $637
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.