How much rates vary
Facilitymedian $1,318 · 10th to 90th $537 to $2,884Professionalmedian $661 · 10th to 90th $457 to $4,074
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 $2,290.87 Typical High $7,585.78 | Facility | None | $812.83 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $758.58 | Professional | None | $436.52 | $512.86 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $977.24 | Professional | None | $288.40 | $446.68 | $977.24 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $1,258.93 | Professional | None | $524.81 | $776.25 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $2,187.76 | Facility | None | $524.81 | $1,096.48 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $891.25 | Professional | None | $457.09 | $616.60 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $5,248.07 | Professional | None | $4,073.80 | $4,073.80 | $5,248.07 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $1,071.52 | Professional | None | $436.52 | $575.44 | $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 $218.78 Median $251.19 Typical High $346.74 | Professional | 52 · Reduced service | $218.78 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $100.00 Typical High $138.04 | Professional | 53 · Discontinued | $87.10 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $512.86 | Professional | 54 · Surgery only | $331.13 | $371.54 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $74.13 Typical High $102.33 | Professional | 55 · Aftercare only | $66.07 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $50.12 Typical High $69.18 | Professional | 56 · Pre-op care only | $43.65 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $346.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $309.03 | $346.74 | $478.63 |
Where Tennessee sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.