How much rates vary
Facilitymedian $1,660 · 10th to 90th $575 to $4,266Professionalmedian $170 · 10th to 90th $76 to $617
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 $138.04 Median $1,778.28 Typical High $6,606.93 | Facility | None | $138.04 | $1,778.28 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $151.36 Typical High $239.88 | Professional | None | $67.61 | $151.36 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $199.53 | Professional | None | $44.67 | $77.62 | $199.53 |
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 $89.13 Median $177.83 Typical High $354.81 | Professional | None | $89.13 | $177.83 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,479.11 Typical High $2,691.53 | Facility | None | $562.34 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $186.21 Typical High $295.12 | Professional | None | $81.28 | $186.21 | $295.12 |
Lucent Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,513.56 | $1,513.56 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $75.86 Median $162.18 Typical High $354.81 | Professional | None | $75.86 | $162.18 | $354.81 |
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 $33.88 Median $58.88 Typical High $109.65 | Professional | 52 · Reduced service | $33.88 | $58.88 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $23.44 Typical High $43.65 | Professional | 53 · Discontinued | $13.49 | $23.44 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $87.10 Typical High $165.96 | Professional | 54 · Surgery only | $51.29 | $87.10 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $17.38 Typical High $33.11 | Professional | 55 · Aftercare only | $10.23 | $17.38 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $11.75 Typical High $21.88 | Professional | 56 · Pre-op care only | $6.76 | $11.75 | $21.88 |
Where Tennessee sits
The same service costs 9.7 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 $4,351MT $447
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.