How much rates vary
Facilitymedian $631 · 10th to 90th $162 to $1,950Professionalmedian $589 · 10th to 90th $427 to $3,715
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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $707.95 | Professional | None | $407.38 | $478.63 | $707.95 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,148.15 | Professional | None | $478.63 | $707.95 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $302.00 Typical High $1,659.59 | Facility | None | $154.88 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $812.83 | Professional | None | $426.58 | $562.34 | $812.83 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,786.30 | Professional | None | $3,715.35 | $3,715.35 | $4,786.30 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $977.24 | Professional | None | $389.05 | $512.86 | $977.24 |
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 $204.17 Median $229.09 Typical High $316.23 | Professional | 52 · Reduced service | $204.17 | $229.09 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $91.20 Typical High $125.89 | Professional | 53 · Discontinued | $81.28 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $346.74 Typical High $467.74 | Professional | 54 · Surgery only | $309.03 | $346.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $69.18 Typical High $93.33 | Professional | 55 · Aftercare only | $61.66 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $45.71 Typical High $63.10 | Professional | 56 · Pre-op care only | $40.74 | $45.71 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $323.59 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $288.40 | $323.59 | $436.52 |
Where Tennessee sits
The same service costs 4.7 times more in New York than in Florida. 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
NY $3,038FL $649
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.