How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,230 to $9,333Professionalmedian $1,148 · 10th to 90th $776 to $7,079
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 $1,548.82 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,548.82 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,380.38 | Professional | None | $776.25 | $912.01 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $1,148.15 Typical High $1,548.82 | Professional | None | $134.90 | $1,148.15 | $1,548.82 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,318.26 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $2,089.30 | Professional | None | $891.25 | $1,288.25 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,897.79 Typical High $10,471.29 | Facility | None | $602.56 | $4,897.79 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,445.44 | Professional | None | $794.33 | $1,023.29 | $1,445.44 |
Lucent Health Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $7,079.46 | Professional | None | $6,456.54 | $6,456.54 | $7,079.46 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,819.70 | Professional | None | $724.44 | $954.99 | $1,819.70 |
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 $389.05 Median $407.38 Typical High $549.54 | Professional | 52 · Reduced service | $389.05 | $407.38 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $223.87 | Professional | 53 · Discontinued | $154.88 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $616.60 Typical High $831.76 | Professional | 54 · Surgery only | $575.44 | $616.60 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $165.96 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $109.65 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $575.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $537.03 | $575.44 | $776.25 |
Where Tennessee sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.