How much rates vary
Facilitymedian $2,188 · 10th to 90th $832 to $4,898Professionalmedian $575 · 10th to 90th $398 to $3,715
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 $416.87 Median $2,630.27 Typical High $6,606.93 | Facility | None | $416.87 | $2,630.27 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $758.58 | Professional | None | $323.59 | $436.52 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $851.14 | Professional | None | $446.68 | $501.19 | $851.14 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,023.29 Median $2,089.30 Typical High $5,128.61 | Facility | None | $1,023.29 | $2,089.30 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $1,071.52 | Professional | None | $446.68 | $616.60 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $3,467.37 | Facility | None | $602.56 | $1,905.46 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $912.01 | Professional | None | $446.68 | $549.54 | $912.01 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $5,011.87 | Professional | None | $3,715.35 | $3,715.35 | $5,011.87 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,754.23 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,754.23 | $5,128.61 |
United Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $1,047.13 | Professional | None | $389.05 | $588.84 | $1,047.13 |
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 $158.49 Median $204.17 Typical High $269.15 | Professional | 52 · Reduced service | $158.49 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $83.18 Typical High $107.15 | Professional | 53 · Discontinued | $64.57 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $309.03 Typical High $407.38 | Professional | 54 · Surgery only | $239.88 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $61.66 Typical High $81.28 | Professional | 55 · Aftercare only | $47.86 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $41.69 Typical High $53.70 | Professional | 56 · Pre-op care only | $32.36 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $288.40 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $223.87 | $288.40 | $380.19 |
Where Tennessee sits
The same service costs 7.2 times more in Vermont than in Maine. 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
VT $9,370ME $1,294
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.