How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,230 to $9,333Professionalmedian $912 · 10th to 90th $603 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 $1,380.38 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,380.38 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,047.13 | Professional | None | $588.84 | $691.83 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,318.26 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,584.89 | Professional | None | $676.08 | $1,000.00 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,786.30 Typical High $10,000.00 | Facility | None | $602.56 | $4,786.30 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,122.02 | Professional | None | $616.60 | $794.33 | $1,122.02 |
Lucent Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $5,495.41 | Professional | None | $4,897.79 | $4,897.79 | $5,495.41 |
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 $562.34 Median $741.31 Typical High $1,412.54 | Professional | None | $562.34 | $741.31 | $1,412.54 |
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 $295.12 Median $316.23 Typical High $436.52 | Professional | 52 · Reduced service | $295.12 | $316.23 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $173.78 | Professional | 53 · Discontinued | $117.49 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $467.74 Typical High $645.65 | Professional | 54 · Surgery only | $436.52 | $467.74 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $128.82 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $436.52 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $407.38 | $436.52 | $602.56 |
Where Tennessee sits
The same service costs 6.4 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 $13,816MT $2,168
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.