How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,000 to $5,754Professionalmedian $1,047 · 10th to 90th $708 to $6,918
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 $707.95 Median $794.33 Typical High $1,230.27 | Professional | None | $707.95 | $794.33 | $1,230.27 |
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 $776.25 Median $1,122.02 Typical High $1,905.46 | Professional | None | $776.25 | $1,122.02 | $1,905.46 |
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 $724.44 Median $870.96 Typical High $1,288.25 | Professional | None | $724.44 | $870.96 | $1,288.25 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,918.31 | Professional | None | $5,754.40 | $5,754.40 | $6,918.31 |
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 $645.65 Median $831.76 Typical High $1,621.81 | Professional | None | $645.65 | $831.76 | $1,621.81 |
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 $354.81 Median $371.54 Typical High $501.19 | Professional | 52 · Reduced service | $354.81 | $371.54 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $151.36 Typical High $204.17 | Professional | 53 · Discontinued | $141.25 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $562.34 Typical High $758.58 | Professional | 54 · Surgery only | $524.81 | $562.34 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $112.20 Typical High $151.36 | Professional | 55 · Aftercare only | $104.71 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $74.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $70.79 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $524.81 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $489.78 | $524.81 | $707.95 |
Where Tennessee sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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
WI $7,619HI $2,493
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.