How much rates vary
Facilitymedian $2,188 · 10th to 90th $871 to $4,786Professionalmedian $646 · 10th to 90th $363 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 $758.58 Median $2,290.87 Typical High $7,585.78 | Facility | None | $758.58 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $870.96 | Professional | None | $346.74 | $512.86 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $1,047.13 | Professional | None | $346.74 | $346.74 | $1,047.13 |
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 $426.58 Median $724.44 Typical High $1,348.96 | Professional | None | $426.58 | $724.44 | $1,348.96 |
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 $363.08 Median $524.81 Typical High $870.96 | Professional | None | $363.08 | $524.81 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $5,011.87 | Professional | None | $4,073.80 | $4,073.80 | $5,011.87 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,691.53 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,691.53 | $5,128.61 |
United Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $1,000.00 | Professional | None | $354.81 | $537.03 | $1,000.00 |
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 $169.82 Median $251.19 Typical High $363.08 | Professional | 52 · Reduced service | $169.82 | $251.19 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $102.33 Typical High $144.54 | Professional | 53 · Discontinued | $69.18 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $380.19 Typical High $549.54 | Professional | 54 · Surgery only | $257.04 | $380.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $75.86 Typical High $109.65 | Professional | 55 · Aftercare only | $51.29 | $75.86 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $51.29 Typical High $72.44 | Professional | 56 · Pre-op care only | $34.67 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $354.81 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $239.88 | $354.81 | $512.86 |
Where Tennessee sits
The same service costs 4.3 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 $6,199MT $1,425
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.