How much rates vary
Facilitymedian $2,239 · 10th to 90th $851 to $4,898Professionalmedian $646 · 10th to 90th $437 to $4,074
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 $457.09 Median $2,754.23 Typical High $6,606.93 | Facility | None | $457.09 | $2,754.23 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $758.58 | Professional | None | $354.81 | $478.63 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $933.25 | Professional | None | $645.65 | $933.25 | $933.25 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,089.30 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $1,202.26 | Professional | None | $501.19 | $676.08 | $1,202.26 |
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 $489.78 Median $616.60 Typical High $1,000.00 | Professional | None | $489.78 | $616.60 | $1,000.00 |
Lucent Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $5,495.41 | Professional | None | $4,073.80 | $4,073.80 | $5,495.41 |
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 $436.52 Median $660.69 Typical High $1,148.15 | Professional | None | $436.52 | $660.69 | $1,148.15 |
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 $177.83 Median $229.09 Typical High $295.12 | Professional | 52 · Reduced service | $177.83 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $91.20 Typical High $120.23 | Professional | 53 · Discontinued | $70.79 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $338.84 Typical High $446.68 | Professional | 54 · Surgery only | $263.03 | $338.84 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $67.61 Typical High $89.13 | Professional | 55 · Aftercare only | $53.70 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $45.71 Typical High $60.26 | Professional | 56 · Pre-op care only | $35.48 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $316.23 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $245.47 | $316.23 | $416.87 |
Where Tennessee sits
The same service costs 4.7 times more in Vermont 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
VT $7,643MT $1,633
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.