How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,072 to $7,413Professionalmedian $603 · 10th to 90th $417 to $3,388
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 $870.96 Median $2,818.38 Typical High $7,585.78 | Facility | None | $870.96 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $660.69 | Professional | None | $416.87 | $457.09 | $660.69 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $912.01 | Professional | None | $575.44 | $630.96 | $912.01 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,122.02 Median $3,090.30 Typical High $8,317.64 | Facility | None | $1,122.02 | $3,090.30 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $1,000.00 | Professional | None | $436.52 | $537.03 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $4,466.84 Typical High $8,128.31 | Facility | None | $660.69 | $4,466.84 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $812.83 | Professional | None | $457.09 | $489.78 | $812.83 |
Lucent Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,311.31 | $3,388.44 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $954.99 | Professional | None | $407.38 | $537.03 | $954.99 |
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 $208.93 Median $223.87 Typical High $316.23 | Professional | 52 · Reduced service | $208.93 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $91.20 Typical High $125.89 | Professional | 53 · Discontinued | $85.11 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $338.84 Typical High $478.63 | Professional | 54 · Surgery only | $316.23 | $338.84 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $67.61 Typical High $95.50 | Professional | 55 · Aftercare only | $63.10 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $63.10 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $63.10 |
Where Tennessee sits
The same service costs 6.1 times more in Alaska 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
AK $8,625MT $1,416
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.