How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,349 to $8,710Professionalmedian $1,445 · 10th to 90th $955 to $7,762
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 $1,318.26 Median $3,311.31 Typical High $7,244.36 | Facility | None | $1,318.26 | $3,311.31 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,737.80 | Professional | None | $933.25 | $1,258.93 | $1,737.80 |
Ambetter Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,778.28 | Professional | None | $891.25 | $1,122.02 | $1,778.28 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $8,317.64 | Facility | None | $1,513.56 | $3,715.35 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,621.81 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,981.07 Typical High $7,943.28 | Facility | None | $831.76 | $3,981.07 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,778.28 | Professional | None | $977.24 | $1,258.93 | $1,778.28 |
Lucent Health Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $8,511.38 | Professional | None | $7,762.47 | $7,762.47 | $8,511.38 |
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 $891.25 Median $1,202.26 Typical High $2,238.72 | Professional | None | $891.25 | $1,202.26 | $2,238.72 |
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 $467.74 Median $501.19 Typical High $676.08 | Professional | 52 · Reduced service | $467.74 | $501.19 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $275.42 | Professional | 53 · Discontinued | $186.21 | $199.53 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $741.31 Typical High $1,023.29 | Professional | 54 · Surgery only | $707.95 | $741.31 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $147.91 Typical High $204.17 | Professional | 55 · Aftercare only | $141.25 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $134.90 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $691.83 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $660.69 | $691.83 | $954.99 |
Where Tennessee sits
The same service costs 4.2 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 $14,362MT $3,396
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.