How much rates vary
Facilitymedian $1,413 · 10th to 90th $513 to $3,890Professionalmedian $2,042 · 10th to 90th $1,318 to $13,183
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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,318.26 | $1,412.54 | $2,187.76 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,513.56 | $1,949.84 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,819.70 | $2,630.27 |
Lucent Health Setting Professional Modifier None Typical Low $13,182.57 Median $13,182.57 Typical High $13,182.57 | Professional | None | $13,182.57 | $13,182.57 | $13,182.57 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,318.26 | $1,949.84 | $3,162.28 |
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 $660.69 Median $707.95 Typical High $1,096.48 | Professional | 52 · Reduced service | $660.69 | $707.95 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $446.68 | Professional | 53 · Discontinued | $263.03 | $281.84 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,047.13 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,000.00 | $1,047.13 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $331.13 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $218.78 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $1,548.82 |
Where Tennessee sits
The same service costs 8.9 times more in Alabama than in Maryland. 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
AL $18,845MD $2,111
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.