How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,514 to $11,220Professionalmedian $1,660 · 10th to 90th $933 to $11,749
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 $1,230.27 Median $2,951.21 Typical High $7,585.78 | Facility | None | $1,230.27 | $2,951.21 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $2,454.71 | Professional | None | $891.25 | $1,230.27 | $2,454.71 |
Ambetter Setting Professional Modifier None Typical Low $645.65 Median $1,288.25 Typical High $1,380.38 | Professional | None | $645.65 | $1,288.25 | $1,380.38 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,022.64 | Facility | None | $1,659.59 | $6,309.57 | $12,022.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $3,311.31 | Professional | None | $1,202.26 | $1,659.59 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,786.30 Typical High $9,772.37 | Facility | None | $831.76 | $4,786.30 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,548.82 | $2,754.23 |
Lucent Health Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Professional | None | $11,748.98 | $11,748.98 | $11,748.98 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $7,079.46 Typical High $11,481.54 | Facility | None | $1,778.28 | $7,079.46 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,412.54 | $1,995.26 | $3,090.30 |
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 $446.68 Median $467.74 Typical High $630.96 | Professional | 52 · Reduced service | $446.68 | $467.74 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $251.19 | Professional | 53 · Discontinued | $177.83 | $186.21 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $954.99 | Professional | 54 · Surgery only | $676.08 | $691.83 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $141.25 Typical High $190.55 | Professional | 55 · Aftercare only | $134.90 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $125.89 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $891.25 |
Where Tennessee sits
The same service costs 6.3 times more in Wyoming than in Hawaii. 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
WY $21,505HI $3,422
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.