How much rates vary
Facilitymedian $1,349 · 10th to 90th $537 to $2,884Professionalmedian $1,047 · 10th to 90th $692 to $6,607
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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,174.90 | Professional | None | $660.69 | $794.33 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,412.54 | Professional | None | $933.25 | $933.25 | $1,412.54 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,778.28 | Professional | None | $794.33 | $1,148.15 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $2,187.76 | Facility | None | $524.81 | $1,096.48 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,288.25 | Professional | None | $691.83 | $912.01 | $1,288.25 |
Lucent Health Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $6,606.93 | Professional | None | $5,495.41 | $5,495.41 | $6,606.93 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,584.89 | Professional | None | $630.96 | $851.14 | $1,584.89 |
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 $331.13 Median $354.81 Typical High $501.19 | Professional | 52 · Reduced service | $331.13 | $354.81 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $199.53 | Professional | 53 · Discontinued | $131.83 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $741.31 | Professional | 54 · Surgery only | $501.19 | $537.03 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $147.91 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $100.00 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $691.83 |
Where Tennessee sits
The same service costs 3.6 times more in Alaska than in Alabama. 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 $5,545AL $1,558
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.