How much rates vary
Facilitymedian $5,012 · 10th to 90th $851 to $11,749Professionalmedian $1,259 · 10th to 90th $759 to $9,772
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 $2,630.27 Median $7,585.78 Typical High $16,595.87 | Facility | None | $2,630.27 | $7,585.78 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $2,818.38 | Professional | None | $758.58 | $933.25 | $2,818.38 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,819.70 Median $7,413.10 Typical High $14,125.38 | Facility | None | $1,819.70 | $7,413.10 | $14,125.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $912.01 Median $1,548.82 Typical High $42,657.95 | Professional | None | $912.01 | $1,548.82 | $42,657.95 |
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 $691.83 Median $1,047.13 Typical High $1,584.89 | Professional | None | $691.83 | $1,047.13 | $1,584.89 |
Lucent Health Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
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 $758.58 Median $1,174.90 Typical High $1,819.70 | Professional | None | $758.58 | $1,174.90 | $1,819.70 |
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 $380.19 Median $398.11 Typical High $630.96 | Professional | 52 · Reduced service | $380.19 | $398.11 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $251.19 | Professional | 53 · Discontinued | $151.36 | $158.49 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $933.25 | Professional | 54 · Surgery only | $562.34 | $602.56 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $190.55 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $125.89 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $125.89 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 51 · Multiple procedures | $1,479.11 | $1,479.11 | $1,479.11 |
Where Tennessee sits
The same service costs 8.4 times more in Alabama than in Kentucky. 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 $15,863KY $1,884
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.