How much rates vary
Facilitymedian $1,995 · 10th to 90th $871 to $4,365Professionalmedian $457 · 10th to 90th $302 to $3,388
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 $316.23 Median $363.08 Typical High $602.56 | Professional | None | $316.23 | $363.08 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $478.63 | Professional | None | $281.84 | $281.84 | $478.63 |
BCBS Tennessee Setting Facility Modifier None Typical Low $933.25 Median $1,621.81 Typical High $3,630.78 | Facility | None | $933.25 | $1,621.81 | $3,630.78 |
BCBS Tennessee Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $758.58 | Professional | None | $338.84 | $457.09 | $758.58 |
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 $302.00 Median $371.54 Typical High $645.65 | Professional | None | $302.00 | $371.54 | $645.65 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $302.00 Median $446.68 Typical High $707.95 | Professional | None | $302.00 | $446.68 | $707.95 |
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 $158.49 Median $162.18 Typical High $234.42 | Professional | 52 · Reduced service | $158.49 | $162.18 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $64.57 Typical High $93.33 | Professional | 53 · Discontinued | $63.10 | $64.57 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $239.88 Typical High $354.81 | Professional | 54 · Surgery only | $234.42 | $239.88 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $70.79 | Professional | 55 · Aftercare only | $46.77 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $32.36 Typical High $46.77 | Professional | 56 · Pre-op care only | $31.62 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $223.87 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $218.78 | $223.87 | $331.13 |
Where Tennessee sits
The same service costs 5.1 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 $5,094MT $991
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.