How much rates vary
Facilitymedian $617 · 10th to 90th $107 to $2,089Professionalmedian $141 · 10th to 90th $87 to $1,000
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 $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $151.36 | Professional | None | $81.28 | $109.65 | $151.36 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $281.84 | Professional | None | $100.00 | $158.49 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $120.23 Typical High $223.87 | Facility | None | $50.12 | $120.23 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $190.55 | Professional | None | $87.10 | $123.03 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,000.00 | $1,288.25 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $218.78 | Professional | None | $81.28 | $114.82 | $218.78 |
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 $40.74 Median $53.70 Typical High $75.86 | Professional | 52 · Reduced service | $40.74 | $53.70 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $21.38 Typical High $30.20 | Professional | 53 · Discontinued | $16.22 | $21.38 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $81.28 Typical High $114.82 | Professional | 54 · Surgery only | $61.66 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.22 Typical High $22.91 | Professional | 55 · Aftercare only | $12.30 | $16.22 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.72 Typical High $15.14 | Professional | 56 · Pre-op care only | $8.13 | $10.72 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $75.86 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $57.54 | $75.86 | $107.15 |
Where Tennessee sits
The same service costs 13.1 times more in Hawaii than in Maryland. 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
HI $2,944MD $224
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.