How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,122 to $7,762Professionalmedian $1,479 · 10th to 90th $1,000 to $7,943
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 $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,513.56 | Professional | None | $954.99 | $1,071.52 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,122.02 Median $3,090.30 Typical High $8,317.64 | Facility | None | $1,122.02 | $3,090.30 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,445.44 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,090.30 Typical High $6,606.93 | Facility | None | $588.84 | $3,090.30 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $2,041.74 | Professional | None | $977.24 | $1,174.90 | $2,041.74 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $8,511.38 Typical High $8,511.38 | Professional | None | $7,943.28 | $8,511.38 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $2,398.83 | Professional | None | $977.24 | $1,412.54 | $2,398.83 |
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 $478.63 Median $501.19 Typical High $758.58 | Professional | 52 · Reduced service | $478.63 | $501.19 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $302.00 | Professional | 53 · Discontinued | $190.55 | $199.53 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $1,148.15 | Professional | 54 · Surgery only | $724.44 | $758.58 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $229.09 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $151.36 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $1,071.52 |
Where Tennessee sits
The same service costs 3.4 times more in Alaska 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
AK $11,546MT $3,436
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.