How much rates vary
Facilitymedian $1,995 · 10th to 90th $871 to $4,786Professionalmedian $661 · 10th to 90th $389 to $4,169
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 $363.08 Median $524.81 Typical High $741.31 | Professional | None | $363.08 | $524.81 | $741.31 |
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 $457.09 Median $758.58 Typical High $1,380.38 | Professional | None | $457.09 | $758.58 | $1,380.38 |
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 $389.05 Median $549.54 Typical High $912.01 | Professional | None | $389.05 | $549.54 | $912.01 |
Lucent Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $5,248.07 | Professional | None | $4,168.69 | $4,168.69 | $5,248.07 |
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 $371.54 Median $549.54 Typical High $1,023.29 | Professional | None | $371.54 | $549.54 | $1,023.29 |
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 $181.97 Median $257.04 Typical High $371.54 | Professional | 52 · Reduced service | $181.97 | $257.04 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $104.71 Typical High $147.91 | Professional | 53 · Discontinued | $72.44 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $389.05 Typical High $562.34 | Professional | 54 · Surgery only | $275.42 | $389.05 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $77.62 Typical High $112.20 | Professional | 55 · Aftercare only | $54.95 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $51.29 Typical High $74.13 | Professional | 56 · Pre-op care only | $36.31 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $363.08 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $257.04 | $363.08 | $524.81 |
Where Tennessee sits
The same service costs 4.4 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 $6,491MT $1,489
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.