How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,288 to $9,333Professionalmedian $741 · 10th to 90th $501 to $4,677
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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $870.96 | Professional | None | $489.78 | $630.96 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $575.44 Median $812.83 Typical High $1,348.96 | Professional | None | $575.44 | $812.83 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,897.79 Typical High $10,232.93 | Facility | None | $741.31 | $4,897.79 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $933.25 | Professional | None | $524.81 | $660.69 | $933.25 |
Lucent Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,677.35 | Professional | None | $4,168.69 | $4,168.69 | $4,677.35 |
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 $446.68 Median $575.44 Typical High $1,174.90 | Professional | None | $446.68 | $575.44 | $1,174.90 |
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 $245.47 Median $263.03 Typical High $354.81 | Professional | 52 · Reduced service | $245.47 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $141.25 | Professional | 53 · Discontinued | $100.00 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $537.03 | Professional | 54 · Surgery only | $371.54 | $398.11 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $107.15 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $70.79 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $501.19 |
Where Tennessee sits
The same service costs 7.5 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 $13,659MT $1,825
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.