How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,413 to $8,128Professionalmedian $851 · 10th to 90th $603 to $6,918
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 $2,344.23 Median $4,570.88 Typical High $10,715.19 | Facility | None | $2,344.23 | $4,570.88 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $933.25 | Professional | None | $588.84 | $616.60 | $933.25 |
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 $660.69 Median $891.25 Typical High $1,513.56 | Professional | None | $660.69 | $891.25 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,630.78 Typical High $6,606.93 | Facility | None | $1,174.90 | $3,630.78 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,230.27 | Professional | None | $588.84 | $707.95 | $1,230.27 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,709.64 | Facility | None | $1,548.82 | $4,570.88 | $8,709.64 |
United Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,445.44 | Professional | None | $588.84 | $812.83 | $1,445.44 |
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 $295.12 Median $309.03 Typical High $467.74 | Professional | 52 · Reduced service | $295.12 | $309.03 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $123.03 Typical High $186.21 | Professional | 53 · Discontinued | $117.49 | $123.03 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $691.83 | Professional | 54 · Surgery only | $446.68 | $467.74 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $141.25 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $61.66 Typical High $93.33 | Professional | 56 · Pre-op care only | $58.88 | $61.66 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $436.52 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $416.87 | $436.52 | $645.65 |
Where Tennessee sits
The same service costs 5.0 times more in Oklahoma 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
OK $10,291MT $2,072
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.