How much rates vary
Facilitymedian $1,514 · 10th to 90th $603 to $3,388Professionalmedian $562 · 10th to 90th $71 to $3,981
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 $794.33 Median $2,290.87 Typical High $7,585.78 | Facility | None | $794.33 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $501.19 Typical High $851.14 | Professional | None | $64.57 | $501.19 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
BCBS Tennessee Setting Facility Modifier None Typical Low $831.76 Median $1,584.89 Typical High $3,467.37 | Facility | None | $831.76 | $1,584.89 | $3,467.37 |
BCBS Tennessee Setting Professional Modifier None Typical Low $72.44 Median $389.05 Typical High $831.76 | Professional | None | $72.44 | $389.05 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,122.02 Typical High $2,691.53 | Facility | None | $588.84 | $1,122.02 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $223.87 Typical High $758.58 | Professional | None | $75.86 | $223.87 | $758.58 |
Lucent Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,786.30 | Professional | None | $3,981.07 | $3,981.07 | $4,786.30 |
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 $69.18 Median $234.42 Typical High $891.25 | Professional | None | $69.18 | $234.42 | $891.25 |
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 $32.36 Median $128.82 Typical High $426.58 | Professional | 52 · Reduced service | $32.36 | $128.82 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $51.29 Typical High $169.82 | Professional | 53 · Discontinued | $12.88 | $51.29 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $162.18 Typical High $630.96 | Professional | 54 · Surgery only | $48.98 | $162.18 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $64.57 Typical High $125.89 | Professional | 55 · Aftercare only | $9.77 | $64.57 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $42.66 Typical High $85.11 | Professional | 56 · Pre-op care only | $6.46 | $42.66 | $85.11 |
Where Tennessee sits
The same service costs 5.6 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 $4,728MT $843
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.