How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,000 to $5,754Professionalmedian $794 · 10th to 90th $513 to $5,495
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 $1,621.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,621.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $870.96 | Professional | None | $489.78 | $575.44 | $870.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,089.30 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $1,318.26 | Professional | None | $588.84 | $831.76 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $3,548.13 | Facility | None | $602.56 | $1,949.84 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,023.29 | Professional | None | $524.81 | $660.69 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $5,495.41 Typical High $5,495.41 | Professional | None | $4,677.35 | $5,495.41 | $5,495.41 |
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 $467.74 Median $660.69 Typical High $1,174.90 | Professional | None | $467.74 | $660.69 | $1,174.90 |
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 $245.47 Median $263.03 Typical High $363.08 | Professional | 52 · Reduced service | $245.47 | $263.03 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $144.54 | Professional | 53 · Discontinued | $97.72 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $549.54 | Professional | 54 · Surgery only | $371.54 | $389.05 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $109.65 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $72.44 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $512.86 |
Where Tennessee sits
The same service costs 4.1 times more in Oklahoma 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
OK $7,594MT $1,845
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.