How much rates vary
Facilitymedian $2,089 · 10th to 90th $871 to $4,786Professionalmedian $631 · 10th to 90th $417 to $3,715
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 $1,479.11 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,479.11 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $758.58 | Professional | None | $407.38 | $457.09 | $758.58 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $1,047.13 | Professional | None | $457.09 | $616.60 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,737.80 Typical High $3,235.94 | Facility | None | $524.81 | $1,737.80 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $851.14 | Professional | None | $416.87 | $489.78 | $851.14 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,715.35 | Professional | None | $3,388.44 | $3,388.44 | $3,715.35 |
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 $407.38 Median $562.34 Typical High $1,000.00 | Professional | None | $407.38 | $562.34 | $1,000.00 |
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 $204.17 Median $213.80 Typical High $323.59 | Professional | 52 · Reduced service | $204.17 | $213.80 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $128.82 | Professional | 53 · Discontinued | $81.28 | $85.11 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $478.63 | Professional | 54 · Surgery only | $309.03 | $323.59 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $97.72 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $64.57 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $446.68 |
Where Tennessee sits
The same service costs 3.6 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 $5,175MT $1,450
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.