How much rates vary
Facilitymedian $1,349 · 10th to 90th $537 to $2,884Professionalmedian $437 · 10th to 90th $288 to $3,548
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 $281.84 Median $331.13 Typical High $501.19 | Professional | None | $281.84 | $331.13 | $501.19 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $776.25 | Professional | None | $331.13 | $467.74 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $2,187.76 | Facility | None | $524.81 | $1,096.48 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $537.03 | Professional | None | $302.00 | $380.19 | $537.03 |
Lucent Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,884.03 | $3,548.13 | $3,548.13 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $676.08 | Professional | None | $257.04 | $346.74 | $676.08 |
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 $141.25 Median $151.36 Typical High $204.17 | Professional | 52 · Reduced service | $141.25 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $61.66 Typical High $81.28 | Professional | 53 · Discontinued | $57.54 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $229.09 Typical High $309.03 | Professional | 54 · Surgery only | $213.80 | $229.09 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $45.71 Typical High $61.66 | Professional | 55 · Aftercare only | $42.66 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $40.74 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $213.80 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $199.53 | $213.80 | $288.40 |
Where Tennessee sits
The same service costs 4.6 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 $4,822MT $1,050
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.