How much rates vary
Facilitymedian $2,188 · 10th to 90th $891 to $4,898Professionalmedian $661 · 10th to 90th $380 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 $891.25 Median $2,818.38 Typical High $7,585.78 | Facility | None | $891.25 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $724.44 | Professional | None | $363.08 | $512.86 | $724.44 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,089.30 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $1,348.96 | Professional | None | $457.09 | $741.31 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $3,548.13 | Facility | None | $602.56 | $1,949.84 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $891.25 | Professional | None | $380.19 | $524.81 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,897.79 | Professional | None | $4,073.80 | $4,073.80 | $4,897.79 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $1,023.29 | Professional | None | $354.81 | $549.54 | $1,023.29 |
7 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 $181.97 Median $257.04 Typical High $363.08 | Professional | 52 · Reduced service | $181.97 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $102.33 Typical High $144.54 | Professional | 53 · Discontinued | $72.44 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $389.05 Typical High $549.54 | Professional | 54 · Surgery only | $269.15 | $389.05 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $77.62 Typical High $109.65 | Professional | 55 · Aftercare only | $53.70 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $51.29 Typical High $72.44 | Professional | 56 · Pre-op care only | $36.31 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $363.08 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $251.19 | $363.08 | $512.86 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 59 · Distinct service | $489.78 | $489.78 | $489.78 |
Where Tennessee sits
The same service costs 5.8 times more in Alabama 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
AL $8,423MT $1,458
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.