How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,230 to $8,710Professionalmedian $692 · 10th to 90th $479 to $5,495
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 $3,388.44 Typical High $7,244.36 | Facility | None | $1,819.70 | $3,388.44 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $831.76 | Professional | None | $478.63 | $537.03 | $831.76 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $8,317.64 | Facility | None | $1,288.25 | $3,388.44 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $1,288.25 | Professional | None | $549.54 | $812.83 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,981.07 Typical High $7,943.28 | Facility | None | $602.56 | $3,981.07 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $912.01 | Professional | None | $501.19 | $630.96 | $912.01 |
Lucent Health Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
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 $457.09 Median $602.56 Typical High $1,122.02 | Professional | None | $457.09 | $602.56 | $1,122.02 |
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 $239.88 Median $251.19 Typical High $354.81 | Professional | 52 · Reduced service | $239.88 | $251.19 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $141.25 | Professional | 53 · Discontinued | $95.50 | $102.33 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $380.19 Typical High $524.81 | Professional | 54 · Surgery only | $354.81 | $380.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $104.71 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $70.79 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $354.81 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $331.13 | $354.81 | $489.78 |
Where Tennessee sits
The same service costs 7.9 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 $13,941MT $1,762
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.