How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,413 to $8,128Professionalmedian $1,023 · 10th to 90th $708 to $7,079
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 $2,344.23 Median $4,570.88 Typical High $10,715.19 | Facility | None | $2,344.23 | $4,570.88 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,230.27 | Professional | None | $707.95 | $812.83 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $8,317.64 | Facility | None | $1,513.56 | $3,715.35 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $1,905.46 | Professional | None | $812.83 | $1,202.26 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,630.78 Typical High $6,606.93 | Facility | None | $1,174.90 | $3,630.78 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,348.96 | Professional | None | $741.31 | $954.99 | $1,348.96 |
Lucent Health Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Professional | None | $7,079.46 | $7,079.46 | $7,079.46 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,659.59 | Professional | None | $645.65 | $870.96 | $1,659.59 |
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 $354.81 Median $380.19 Typical High $512.86 | Professional | 52 · Reduced service | $354.81 | $380.19 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $151.36 Typical High $204.17 | Professional | 53 · Discontinued | $141.25 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $758.58 | Professional | 54 · Surgery only | $537.03 | $562.34 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $151.36 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $75.86 Typical High $102.33 | Professional | 56 · Pre-op care only | $70.79 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $707.95 |
Where Tennessee sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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
AK $10,315KY $2,095
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.