How much rates vary
Facilitymedian $2,138 · 10th to 90th $891 to $4,898Professionalmedian $661 · 10th to 90th $363 to $3,802
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 $316.23 Median $489.78 Typical High $707.95 | Professional | None | $316.23 | $489.78 | $707.95 |
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 $416.87 Median $758.58 Typical High $1,318.26 | Professional | None | $416.87 | $758.58 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,949.84 Typical High $3,548.13 | Facility | None | $524.81 | $1,949.84 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $891.25 | Professional | None | $316.23 | $489.78 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,570.88 | Professional | None | $3,801.89 | $3,801.89 | $4,570.88 |
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 $588.84 Typical High $1,071.52 | Professional | None | $354.81 | $588.84 | $1,071.52 |
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 $158.49 Median $245.47 Typical High $354.81 | Professional | 52 · Reduced service | $158.49 | $245.47 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $97.72 Typical High $141.25 | Professional | 53 · Discontinued | $63.10 | $97.72 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $371.54 Typical High $537.03 | Professional | 54 · Surgery only | $234.42 | $371.54 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $74.13 Typical High $107.15 | Professional | 55 · Aftercare only | $46.77 | $74.13 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $48.98 Typical High $70.79 | Professional | 56 · Pre-op care only | $31.62 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $346.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $218.78 | $346.74 | $501.19 |
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 $6,451MT $1,460
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.