How much rates vary
Facilitymedian $1,995 · 10th to 90th $813 to $4,786Professionalmedian $398 · 10th to 90th $251 to $2,951
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 $331.13 Median $2,290.87 Typical High $6,606.93 | Facility | None | $331.13 | $2,290.87 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $524.81 | Professional | None | $223.87 | $316.23 | $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 $239.88 Median $331.13 Typical High $575.44 | Professional | None | $239.88 | $331.13 | $575.44 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,630.78 | Professional | None | $2,951.21 | $2,951.21 | $3,630.78 |
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 $281.84 Median $389.05 Typical High $676.08 | Professional | None | $281.84 | $389.05 | $676.08 |
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 $112.20 Median $158.49 Typical High $213.80 | Professional | 52 · Reduced service | $112.20 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $63.10 Typical High $87.10 | Professional | 53 · Discontinued | $45.71 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $323.59 | Professional | 54 · Surgery only | $169.82 | $239.88 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $47.86 Typical High $64.57 | Professional | 55 · Aftercare only | $33.88 | $47.86 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $31.62 Typical High $42.66 | Professional | 56 · Pre-op care only | $22.39 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $223.87 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $158.49 | $223.87 | $302.00 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 51 · Multiple procedures | $208.93 | $208.93 | $208.93 |
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 $6,346MT $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.