How much rates vary
Facilitymedian $1,995 · 10th to 90th $832 to $4,898Professionalmedian $389 · 10th to 90th $251 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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $426.58 | Professional | None | $239.88 | $288.40 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $354.81 | Professional | None | $218.78 | $218.78 | $354.81 |
BCBS Tennessee Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $5,128.61 | Facility | None | $933.25 | $1,905.46 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $660.69 | Professional | None | $288.40 | $426.58 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,698.24 Typical High $3,548.13 | Facility | None | $389.05 | $1,698.24 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $478.63 | Professional | None | $251.19 | $331.13 | $478.63 |
Lucent Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,981.07 Typical High $3,981.07 | Professional | None | $2,630.27 | $3,981.07 | $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 $229.09 Median $316.23 Typical High $602.56 | Professional | None | $229.09 | $316.23 | $602.56 |
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 $120.23 Median $131.83 Typical High $177.83 | Professional | 52 · Reduced service | $120.23 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $52.48 Typical High $70.79 | Professional | 53 · Discontinued | $48.98 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $194.98 Typical High $269.15 | Professional | 54 · Surgery only | $181.97 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.90 Typical High $53.70 | Professional | 55 · Aftercare only | $36.31 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $26.30 Typical High $35.48 | Professional | 56 · Pre-op care only | $23.99 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $181.97 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $169.82 | $181.97 | $251.19 |
Where Tennessee sits
The same service costs 7.3 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 $6,269MT $863
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.