How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,148 to $5,248Professionalmedian $646 · 10th to 90th $427 to $3,981
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 $4,570.88 Typical High $10,715.19 | Facility | None | $1,819.70 | $4,570.88 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $776.25 | Professional | None | $416.87 | $524.81 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $5,495.41 | Facility | None | $1,148.15 | $2,290.87 | $5,495.41 |
BCBS Tennessee Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,122.02 | Professional | None | $478.63 | $707.95 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,041.74 Typical High $5,248.07 | Facility | None | $1,174.90 | $2,041.74 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $794.33 | Professional | None | $446.68 | $549.54 | $794.33 |
Lucent Health Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,981.07 | Professional | None | $3,548.13 | $3,548.13 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
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 $208.93 Median $223.87 Typical High $302.00 | Professional | 52 · Reduced service | $208.93 | $223.87 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $120.23 | Professional | 53 · Discontinued | $83.18 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $338.84 Typical High $457.09 | Professional | 54 · Surgery only | $316.23 | $338.84 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $67.61 Typical High $91.20 | Professional | 55 · Aftercare only | $63.10 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $60.26 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $316.23 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $295.12 | $316.23 | $426.58 |
Where Tennessee sits
The same service costs 5.4 times more in Alabama 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
AL $8,312MT $1,553
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.