How much rates vary
Facilitymedian $2,188 · 10th to 90th $871 to $4,898Professionalmedian $324 · 10th to 90th $234 to $2,089
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 $812.83 Median $2,630.27 Typical High $7,585.78 | Facility | None | $812.83 | $2,630.27 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $407.38 | Professional | None | $234.42 | $281.84 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $467.74 | Professional | None | $281.84 | $281.84 | $467.74 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $588.84 | Professional | None | $257.04 | $346.74 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,041.74 Typical High $3,715.35 | Facility | None | $524.81 | $2,041.74 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $512.86 | Professional | None | $223.87 | $295.12 | $512.86 |
Lucent Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $229.09 Median $346.74 Typical High $549.54 | Professional | None | $229.09 | $346.74 | $549.54 |
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 $117.49 Median $131.83 Typical High $162.18 | Professional | 52 · Reduced service | $117.49 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $53.70 Typical High $64.57 | Professional | 53 · Discontinued | $46.77 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $199.53 Typical High $245.47 | Professional | 54 · Surgery only | $177.83 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $39.81 Typical High $48.98 | Professional | 55 · Aftercare only | $35.48 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $26.30 Typical High $32.36 | Professional | 56 · Pre-op care only | $23.44 | $26.30 | $32.36 |
Where Tennessee sits
The same service costs 8.6 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 $6,380MT $743
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.