How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,148 to $7,586Professionalmedian $692 · 10th to 90th $457 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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $776.25 | Professional | None | $446.68 | $512.86 | $776.25 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,412.54 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,412.54 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $1,202.26 | Professional | None | $512.86 | $758.58 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,801.89 Typical High $7,943.28 | Facility | None | $741.31 | $3,801.89 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $851.14 | Professional | None | $467.74 | $602.56 | $851.14 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,073.80 | Professional | None | $3,715.35 | $3,715.35 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $1,047.13 | Professional | None | $416.87 | $562.34 | $1,047.13 |
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 $223.87 Median $234.42 Typical High $323.59 | Professional | 52 · Reduced service | $223.87 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $128.82 | Professional | 53 · Discontinued | $89.13 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $489.78 | Professional | 54 · Surgery only | $331.13 | $354.81 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $97.72 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $64.57 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $331.13 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $309.03 | $331.13 | $457.09 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 51 · Multiple procedures | $467.74 | $467.74 | $467.74 |
Where Tennessee sits
The same service costs 7.5 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 $12,189MT $1,626
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.