How much rates vary
Facilitymedian $1,995 · 10th to 90th $871 to $4,365Professionalmedian $389 · 10th to 90th $275 to $6,918
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 $281.84 Median $316.23 Typical High $478.63 | Professional | None | $281.84 | $316.23 | $478.63 |
BCBS Tennessee Setting Facility Modifier None Typical Low $912.01 Median $1,621.81 Typical High $3,630.78 | Facility | None | $912.01 | $1,621.81 | $3,630.78 |
BCBS Tennessee Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $691.83 | Professional | None | $302.00 | $407.38 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,258.93 Typical High $3,311.31 | Facility | None | $741.31 | $1,258.93 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $588.84 | Professional | None | $269.15 | $338.84 | $588.84 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $645.65 | Professional | None | $275.42 | $398.11 | $645.65 |
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 $141.25 Median $158.49 Typical High $194.98 | Professional | 52 · Reduced service | $141.25 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $63.10 Typical High $77.62 | Professional | 53 · Discontinued | $56.23 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $288.40 | Professional | 54 · Surgery only | $208.93 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $57.54 | Professional | 55 · Aftercare only | $41.69 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $31.62 Typical High $38.90 | Professional | 56 · Pre-op care only | $28.18 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $218.78 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $194.98 | $218.78 | $269.15 |
Where Tennessee sits
The same service costs 6.6 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 $6,126MT $925
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.