How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,230 to $8,318Professionalmedian $1,023 · 10th to 90th $676 to $12,023
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 $1,513.56 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,513.56 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,174.90 | Professional | None | $660.69 | $812.83 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,412.54 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,412.54 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,778.28 | Professional | None | $776.25 | $1,122.02 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,981.07 Typical High $7,943.28 | Facility | None | $741.31 | $3,981.07 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,258.93 | Professional | None | $691.83 | $891.25 | $1,258.93 |
Lucent Health Setting Professional Modifier None Typical Low $6,025.60 Median $12,022.64 Typical High $12,022.64 | Professional | None | $6,025.60 | $12,022.64 | $12,022.64 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,548.82 | Professional | None | $616.60 | $812.83 | $1,548.82 |
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 $346.74 Typical High $478.63 | Professional | 52 · Reduced service | $331.13 | $346.74 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $190.55 | Professional | 53 · Discontinued | $131.83 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $524.81 Typical High $724.44 | Professional | 54 · Surgery only | $489.78 | $524.81 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $104.71 Typical High $144.54 | Professional | 55 · Aftercare only | $97.72 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $489.78 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $457.09 | $489.78 | $676.08 |
Where Tennessee sits
The same service costs 5.7 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 $13,613MT $2,377
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.