How much rates vary
Facilitymedian $1,148 · 10th to 90th $407 to $2,951Professionalmedian $245 · 10th to 90th $72 to $1,950
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 $512.86 Median $2,290.87 Typical High $7,585.78 | Facility | None | $512.86 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $213.80 Typical High $389.05 | Professional | None | $67.61 | $213.80 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $2,630.27 | Facility | None | $524.81 | $1,096.48 | $2,630.27 |
BCBS Tennessee Setting Professional Modifier None Typical Low $72.44 Median $204.17 Typical High $363.08 | Professional | None | $72.44 | $204.17 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $575.44 Typical High $2,691.53 | Facility | None | $295.12 | $575.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $199.53 Typical High $338.84 | Professional | None | $81.28 | $199.53 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,949.84 | $1,949.84 | $2,691.53 |
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 $70.79 Median $190.55 Typical High $354.81 | Professional | None | $70.79 | $190.55 | $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 $79.43 Typical High $194.98 | Professional | 52 · Reduced service | $33.88 | $79.43 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $31.62 Typical High $77.62 | Professional | 53 · Discontinued | $13.49 | $31.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $120.23 Typical High $288.40 | Professional | 54 · Surgery only | $50.12 | $120.23 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $23.99 Typical High $58.88 | Professional | 55 · Aftercare only | $10.23 | $23.99 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $18.62 Typical High $38.90 | Professional | 56 · Pre-op care only | $6.76 | $18.62 | $38.90 |
Where Tennessee sits
The same service costs 9.0 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 $4,579MT $507
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.