How much rates vary
Facilitymedian $2,042 · 10th to 90th $832 to $4,786Professionalmedian $295 · 10th to 90th $195 to $1,778
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 $204.17 Median $208.93 Typical High $309.03 | Professional | None | $204.17 | $208.93 | $309.03 |
BCBS Tennessee Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $5,128.61 | Facility | None | $933.25 | $1,905.46 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $501.19 | Professional | None | $218.78 | $295.12 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,778.28 Typical High $3,715.35 | Facility | None | $389.05 | $1,778.28 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $426.58 | Professional | None | $194.98 | $245.47 | $426.58 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $194.98 Median $295.12 Typical High $457.09 | Professional | None | $194.98 | $295.12 | $457.09 |
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 $102.33 Median $104.71 Typical High $151.36 | Professional | 52 · Reduced service | $102.33 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $41.69 Typical High $61.66 | Professional | 53 · Discontinued | $40.74 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $158.49 Typical High $229.09 | Professional | 54 · Surgery only | $154.88 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $31.62 Typical High $45.71 | Professional | 55 · Aftercare only | $30.90 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.89 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.42 | $20.89 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $147.91 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $144.54 | $147.91 | $213.80 |
Where Tennessee sits
The same service costs 9.6 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 $6,197MT $647
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.