How much rates vary
Facilitymedian $2,630 · 10th to 90th $1,023 to $5,754Professionalmedian $724 · 10th to 90th $525 to $5,012
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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $812.83 | Professional | None | $524.81 | $588.84 | $812.83 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,137.96 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,174.90 | Professional | None | $537.03 | $660.69 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,089.30 Typical High $3,801.89 | Facility | None | $741.31 | $2,089.30 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $954.99 | Professional | None | $562.34 | $630.96 | $954.99 |
Lucent Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $5,011.87 | Professional | None | $4,265.80 | $4,265.80 | $5,011.87 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $1,230.27 | Professional | None | $524.81 | $616.60 | $1,230.27 |
7 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 $263.03 Median $288.40 Typical High $398.11 | Professional | 52 · Reduced service | $263.03 | $288.40 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $158.49 | Professional | 53 · Discontinued | $104.71 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $426.58 Typical High $588.84 | Professional | 54 · Surgery only | $398.11 | $426.58 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $85.11 Typical High $120.23 | Professional | 55 · Aftercare only | $79.43 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $57.54 Typical High $79.43 | Professional | 56 · Pre-op care only | $52.48 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $398.11 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $371.54 | $398.11 | $549.54 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $776.25 |
Where Tennessee sits
The same service costs 4.0 times more in Oklahoma 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
OK $7,771MT $1,932
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.