How much rates vary
Facilitymedian $2,818 · 10th to 90th $933 to $6,166Professionalmedian $1,096 · 10th to 90th $741 to $6,166
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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,348.96 | Professional | None | $758.58 | $851.14 | $1,348.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $977.24 Median $2,398.83 Typical High $6,309.57 | Facility | None | $977.24 | $2,398.83 | $6,309.57 |
BCBS Tennessee Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,905.46 | Professional | None | $831.76 | $1,096.48 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $2,818.38 Typical High $5,888.44 | Facility | None | $389.05 | $2,818.38 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,584.89 | Professional | None | $724.44 | $912.01 | $1,584.89 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,165.95 | Professional | None | $5,754.40 | $5,754.40 | $6,165.95 |
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 $724.44 Median $1,047.13 Typical High $1,737.80 | Professional | None | $724.44 | $1,047.13 | $1,737.80 |
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 $380.19 Median $426.58 Typical High $524.81 | Professional | 52 · Reduced service | $380.19 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $208.93 | Professional | 53 · Discontinued | $151.36 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $776.25 | Professional | 54 · Surgery only | $562.34 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $158.49 | Professional | 55 · Aftercare only | $112.20 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $104.71 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $724.44 |
Where Tennessee sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $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.