How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,288 to $10,965Professionalmedian $6,026 · 10th to 90th $447 to $40,738
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 $2,630.27 Median $6,025.60 Typical High $11,220.18 | Facility | None | $2,630.27 | $6,025.60 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $2,951.21 Typical High $8,912.51 | Professional | None | $407.38 | $2,951.21 | $8,912.51 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,288.25 Median $4,897.79 Typical High $10,471.29 | Facility | None | $1,288.25 | $4,897.79 | $10,471.29 |
BCBS Tennessee Setting Professional Modifier None Typical Low $457.09 Median $4,466.84 Typical High $10,000.00 | Professional | None | $457.09 | $4,466.84 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $8,128.31 Typical High $16,595.87 | Facility | None | $602.56 | $8,128.31 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $1,318.26 Typical High $9,120.11 | Professional | None | $478.63 | $1,318.26 | $9,120.11 |
Lucent Health Setting Professional Modifier None Typical Low $40,738.03 Median $50,118.72 Typical High $50,118.72 | Professional | None | $40,738.03 | $50,118.72 | $50,118.72 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $446.68 Median $5,248.07 Typical High $11,220.18 | Professional | None | $446.68 | $5,248.07 | $11,220.18 |
6 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 $204.17 Median $812.83 Typical High $4,466.84 | Professional | 52 · Reduced service | $204.17 | $812.83 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $323.59 Typical High $1,778.28 | Professional | 53 · Discontinued | $81.28 | $323.59 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $1,230.27 Typical High $6,760.83 | Professional | 54 · Surgery only | $309.03 | $1,230.27 | $6,760.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $245.47 Typical High $1,348.96 | Professional | 55 · Aftercare only | $61.66 | $245.47 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $162.18 Typical High $891.25 | Professional | 56 · Pre-op care only | $40.74 | $162.18 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $1,148.15 Typical High $6,309.57 | Professional | 78 · Unplanned return to OR | $288.40 | $1,148.15 | $6,309.57 |
Where Tennessee sits
The same service costs 4.1 times more in Iowa than in Delaware. 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
IA $18,453DE $4,539
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.