How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,096 to $9,333Professionalmedian $2,138 · 10th to 90th $1,445 to $12,589
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 $1,380.38 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,584.89 | $2,454.71 |
Ambetter Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,513.56 Median $4,897.79 Typical High $10,471.29 | Facility | None | $1,513.56 | $4,897.79 | $10,471.29 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,659.59 Median $2,398.83 Typical High $3,801.89 | Professional | None | $1,659.59 | $2,398.83 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $7,244.36 Typical High $14,791.08 | Facility | None | $602.56 | $7,244.36 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,445.44 | $1,905.46 | $2,630.27 |
Lucent Health Setting Professional Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $12,589.25 | Professional | None | $11,481.54 | $11,481.54 | $12,589.25 |
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 $1,288.25 Median $1,737.80 Typical High $3,311.31 | Professional | None | $1,288.25 | $1,737.80 | $3,311.31 |
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 $691.83 Median $741.31 Typical High $1,000.00 | Professional | 52 · Reduced service | $691.83 | $741.31 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $295.12 Typical High $398.11 | Professional | 53 · Discontinued | $281.84 | $295.12 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,122.02 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,047.13 | $1,122.02 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $302.00 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $147.91 Typical High $199.53 | Professional | 56 · Pre-op care only | $138.04 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,047.13 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $977.24 | $1,047.13 | $1,412.54 |
Where Tennessee sits
The same service costs 6.3 times more in Alaska than in Texas. 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
AK $16,928TX $2,675
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.