How much rates vary
Facilitymedian $2,570 · 10th to 90th $933 to $6,310Professionalmedian $813 · 10th to 90th $195 to $5,248
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 $812.83 Median $2,290.87 Typical High $7,585.78 | Facility | None | $812.83 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $812.83 Typical High $1,479.11 | Professional | None | $177.83 | $812.83 | $1,479.11 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $645.65 | Professional | None | $229.09 | $371.54 | $645.65 |
BCBS Tennessee Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $5,128.61 | Facility | None | $933.25 | $1,905.46 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $218.78 Median $645.65 Typical High $1,412.54 | Professional | None | $218.78 | $645.65 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $4,570.88 | Facility | None | $537.03 | $2,511.89 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $549.54 Typical High $1,348.96 | Professional | None | $194.98 | $549.54 | $1,348.96 |
Lucent Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $6,606.93 | Professional | None | $5,248.07 | $5,248.07 | $6,606.93 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $8,709.64 | Facility | None | $1,202.26 | $3,801.89 | $8,709.64 |
United Setting Professional Modifier None Typical Low $199.53 Median $691.83 Typical High $1,584.89 | Professional | None | $199.53 | $691.83 | $1,584.89 |
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 $89.13 Median $165.96 Typical High $676.08 | Professional | 52 · Reduced service | $89.13 | $165.96 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $66.07 Typical High $269.15 | Professional | 53 · Discontinued | $36.31 | $66.07 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $245.47 Typical High $1,000.00 | Professional | 54 · Surgery only | $134.90 | $245.47 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $50.12 Typical High $199.53 | Professional | 55 · Aftercare only | $26.92 | $50.12 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $33.11 Typical High $134.90 | Professional | 56 · Pre-op care only | $17.78 | $33.11 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $229.09 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $125.89 | $229.09 | $933.25 |
Where Tennessee sits
The same service costs 5.1 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 $7,315MT $1,443
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.