How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,148 to $7,762Professionalmedian $871 · 10th to 90th $575 to $5,248
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 $562.34 Median $660.69 Typical High $1,000.00 | Professional | None | $562.34 | $660.69 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
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 $645.65 Median $954.99 Typical High $1,513.56 | Professional | None | $645.65 | $954.99 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,623.41 Typical High $11,748.98 | Facility | None | $741.31 | $5,623.41 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,071.52 | Professional | None | $602.56 | $758.58 | $1,071.52 |
Lucent Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,248.07 | Professional | None | $5,011.87 | $5,011.87 | $5,248.07 |
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 $537.03 Median $707.95 Typical High $1,348.96 | Professional | None | $537.03 | $707.95 | $1,348.96 |
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 $281.84 Median $302.00 Typical High $416.87 | Professional | 52 · Reduced service | $281.84 | $302.00 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $120.23 Typical High $165.96 | Professional | 53 · Discontinued | $112.20 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $446.68 Typical High $616.60 | Professional | 54 · Surgery only | $426.58 | $446.68 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $125.89 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $83.18 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $416.87 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $398.11 | $416.87 | $575.44 |
Where Tennessee sits
The same service costs 5.4 times more in Alaska 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
AK $11,142MT $2,070
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.