How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,000 to $5,754Professionalmedian $1,622 · 10th to 90th $1,047 to $10,000
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 $1,479.11 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,479.11 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,230.27 | $1,949.84 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,202.26 | $1,905.46 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,949.84 Typical High $3,548.13 | Facility | None | $524.81 | $1,949.84 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,513.56 Typical High $2,041.74 | Professional | None | $977.24 | $1,513.56 | $2,041.74 |
Lucent Health Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $10,000.00 | Professional | None | $9,120.11 | $9,120.11 | $10,000.00 |
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 $645.65 Median $1,202.26 Typical High $2,570.40 | Professional | None | $645.65 | $1,202.26 | $2,570.40 |
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 $549.54 Median $575.44 Typical High $794.33 | Professional | 52 · Reduced service | $549.54 | $575.44 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $316.23 | Professional | 53 · Discontinued | $218.78 | $234.42 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $870.96 Typical High $1,202.26 | Professional | 54 · Surgery only | $831.76 | $870.96 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $239.88 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $812.83 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $776.25 | $812.83 | $1,122.02 |
Where Tennessee sits
The same service costs 3.7 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 $9,494KY $2,537
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.