How much rates vary
Facilitymedian $1,202 · 10th to 90th $513 to $2,818Professionalmedian $214 · 10th to 90th $155 to $1,995
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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $239.88 | Professional | None | $154.88 | $169.82 | $239.88 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $371.54 | Professional | None | $162.18 | $194.98 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $1,659.59 | Facility | None | $389.05 | $831.76 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $338.84 | Professional | None | $173.78 | $186.21 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $154.88 Median $229.09 Typical High $371.54 | Professional | None | $154.88 | $229.09 | $371.54 |
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 $77.62 Median $83.18 Typical High $117.49 | Professional | 52 · Reduced service | $77.62 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $33.11 Typical High $46.77 | Professional | 53 · Discontinued | $30.90 | $33.11 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $123.03 Typical High $173.78 | Professional | 54 · Surgery only | $114.82 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $24.55 Typical High $34.67 | Professional | 55 · Aftercare only | $22.91 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.60 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.49 | $16.60 | $23.44 |
Where Tennessee sits
The same service costs 7.7 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 $4,047MT $526
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.