How much rates vary
Facilitymedian $10,000 · 10th to 90th $1,585 to $23,988Professionalmedian $5,888 · 10th to 90th $537 to $16,596
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 $501.19 Median $4,570.88 Typical High $10,000.00 | Professional | None | $501.19 | $4,570.88 | $10,000.00 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,584.89 Median $7,413.10 Typical High $14,125.38 | Facility | None | $1,584.89 | $7,413.10 | $14,125.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $588.84 Median $1,778.28 Typical High $12,302.69 | Professional | None | $588.84 | $1,778.28 | $12,302.69 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $14,454.40 Typical High $26,915.35 | Facility | None | $588.84 | $14,454.40 | $26,915.35 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $1,584.89 Typical High $10,715.19 | Professional | None | $537.03 | $1,584.89 | $10,715.19 |
Lucent Health Setting Professional Modifier None Typical Low $37,153.52 Median $51,286.14 Typical High $51,286.14 | Professional | None | $37,153.52 | $51,286.14 | $51,286.14 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $14,791.08 Typical High $26,915.35 | Facility | None | $5,888.44 | $14,791.08 | $26,915.35 |
United Setting Professional Modifier None Typical Low $562.34 Median $5,888.44 Typical High $12,302.69 | Professional | None | $562.34 | $5,888.44 | $12,302.69 |
5 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 $251.19 Median $457.09 Typical High $5,011.87 | Professional | 52 · Reduced service | $251.19 | $457.09 | $5,011.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $181.97 Typical High $1,995.26 | Professional | 53 · Discontinued | $100.00 | $181.97 | $1,995.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $691.83 Typical High $7,413.10 | Professional | 54 · Surgery only | $371.54 | $691.83 | $7,413.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $138.04 Typical High $1,513.56 | Professional | 55 · Aftercare only | $75.86 | $138.04 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $91.20 Typical High $1,000.00 | Professional | 56 · Pre-op care only | $50.12 | $91.20 | $1,000.00 |
Where Tennessee sits
The same service costs 6.1 times more in Alaska than in Vermont. 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 $33,081VT $5,424
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.