How much rates vary
Facilitymedian $1,995 · 10th to 90th $871 to $4,786Professionalmedian $617 · 10th to 90th $363 to $4,677
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 $812.83 Median $2,398.83 Typical High $7,585.78 | Facility | None | $812.83 | $2,398.83 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $741.31 | Professional | None | $346.74 | $478.63 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $630.96 | Professional | None | $512.86 | $630.96 | $630.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $1,258.93 | Professional | None | $436.52 | $691.83 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,479.11 Typical High $2,691.53 | Facility | None | $524.81 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $831.76 | Professional | None | $363.08 | $524.81 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,677.35 | $4,786.30 | $4,786.30 |
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 $354.81 Median $512.86 Typical High $954.99 | Professional | None | $354.81 | $512.86 | $954.99 |
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 $173.78 Median $239.88 Typical High $338.84 | Professional | 52 · Reduced service | $173.78 | $239.88 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $95.50 Typical High $134.90 | Professional | 53 · Discontinued | $69.18 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $363.08 Typical High $512.86 | Professional | 54 · Surgery only | $263.03 | $363.08 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $72.44 Typical High $102.33 | Professional | 55 · Aftercare only | $52.48 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $47.86 Typical High $67.61 | Professional | 56 · Pre-op care only | $34.67 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $338.84 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $245.47 | $338.84 | $478.63 |
Where Tennessee sits
The same service costs 4.7 times more in Colorado 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
CO $6,464MT $1,390
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.