How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,000 to $5,754Professionalmedian $457 · 10th to 90th $309 to $3,090
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 $1,380.38 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,380.38 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $575.44 | Professional | None | $316.23 | $338.84 | $575.44 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,089.30 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $776.25 | Professional | None | $346.74 | $457.09 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $3,715.35 | Facility | None | $602.56 | $2,041.74 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $660.69 | Professional | None | $302.00 | $380.19 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,715.35 Typical High $6,456.54 | Facility | None | $1,202.26 | $3,715.35 | $6,456.54 |
United Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $724.44 | Professional | None | $309.03 | $446.68 | $724.44 |
7 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 $158.49 Median $162.18 Typical High $239.88 | Professional | 52 · Reduced service | $158.49 | $162.18 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $95.50 | Professional | 53 · Discontinued | $63.10 | $66.07 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $245.47 Typical High $354.81 | Professional | 54 · Surgery only | $239.88 | $245.47 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $48.98 Typical High $70.79 | Professional | 55 · Aftercare only | $47.86 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $47.86 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $229.09 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $223.87 | $229.09 | $331.13 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 50 · Both sides | $645.65 | $645.65 | $645.65 |
Where Tennessee sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.