How much rates vary
Facilitymedian $1,995 · 10th to 90th $813 to $4,786Professionalmedian $427 · 10th to 90th $269 to $3,236
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 $363.08 Median $2,290.87 Typical High $6,606.93 | Facility | None | $363.08 | $2,290.87 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $524.81 | Professional | None | $218.78 | $346.74 | $524.81 |
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 $281.84 Median $416.87 Typical High $616.60 | Professional | None | $281.84 | $416.87 | $616.60 |
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 $288.40 Median $436.52 Typical High $724.44 | Professional | None | $288.40 | $436.52 | $724.44 |
Lucent Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Professional | None | $3,235.94 | $3,235.94 | $4,365.16 |
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 $263.03 Median $398.11 Typical High $676.08 | Professional | None | $263.03 | $398.11 | $676.08 |
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 $109.65 Median $173.78 Typical High $239.88 | Professional | 52 · Reduced service | $109.65 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $69.18 Typical High $95.50 | Professional | 53 · Discontinued | $43.65 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $257.04 Typical High $354.81 | Professional | 54 · Surgery only | $162.18 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $52.48 Typical High $70.79 | Professional | 55 · Aftercare only | $32.36 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $34.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $21.88 | $34.67 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $239.88 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $151.36 | $239.88 | $331.13 |
Where Tennessee sits
The same service costs 6.1 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 $6,367MT $1,043
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.