How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,288 to $8,710Professionalmedian $871 · 10th to 90th $589 to $5,370
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 $575.44 Median $676.08 Typical High $1,023.29 | Professional | None | $575.44 | $676.08 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
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 $660.69 Median $977.24 Typical High $1,548.82 | Professional | None | $660.69 | $977.24 | $1,548.82 |
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 $602.56 Median $776.25 Typical High $1,096.48 | Professional | None | $602.56 | $776.25 | $1,096.48 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,370.32 | Professional | None | $4,786.30 | $4,786.30 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $1,380.38 | Professional | None | $549.54 | $707.95 | $1,380.38 |
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 $288.40 Median $309.03 Typical High $416.87 | Professional | 52 · Reduced service | $288.40 | $309.03 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $123.03 Typical High $169.82 | Professional | 53 · Discontinued | $114.82 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $457.09 Typical High $630.96 | Professional | 54 · Surgery only | $436.52 | $457.09 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $91.20 Typical High $125.89 | Professional | 55 · Aftercare only | $87.10 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $61.66 Typical High $83.18 | Professional | 56 · Pre-op care only | $57.54 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $426.58 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $407.38 | $426.58 | $588.84 |
Where Tennessee sits
The same service costs 6.5 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 $13,795MT $2,119
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.