How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,148 to $7,586Professionalmedian $1,230 · 10th to 90th $813 to $7,762
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 $812.83 Median $912.01 Typical High $1,412.54 | Professional | None | $812.83 | $912.01 | $1,412.54 |
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 $912.01 Median $1,318.26 Typical High $2,187.76 | Professional | None | $912.01 | $1,318.26 | $2,187.76 |
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 $831.76 Median $1,023.29 Typical High $1,513.56 | Professional | None | $831.76 | $1,023.29 | $1,513.56 |
Lucent Health Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $7,762.47 | Professional | None | $6,760.83 | $6,760.83 | $7,762.47 |
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 $741.31 Median $1,000.00 Typical High $1,862.09 | Professional | None | $741.31 | $1,000.00 | $1,862.09 |
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 $407.38 Median $426.58 Typical High $588.84 | Professional | 52 · Reduced service | $407.38 | $426.58 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $234.42 | Professional | 53 · Discontinued | $162.18 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $645.65 Typical High $870.96 | Professional | 54 · Surgery only | $602.56 | $645.65 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $173.78 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $85.11 Typical High $117.49 | Professional | 56 · Pre-op care only | $81.28 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $602.56 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $562.34 | $602.56 | $812.83 |
Where Tennessee sits
The same service costs 4.2 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 $12,508MT $2,994
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.