How much rates vary
Facilitymedian $2,344 · 10th to 90th $891 to $6,607Professionalmedian $513 · 10th to 90th $339 to $3,548
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 $354.81 Median $363.08 Typical High $549.54 | Professional | None | $354.81 | $363.08 | $549.54 |
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 $380.19 Median $512.86 Typical High $851.14 | Professional | None | $380.19 | $512.86 | $851.14 |
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 $338.84 Median $426.58 Typical High $724.44 | Professional | None | $338.84 | $426.58 | $724.44 |
Lucent Health Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $812.83 | Professional | None | $338.84 | $489.78 | $812.83 |
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 $177.83 Median $181.97 Typical High $263.03 | Professional | 52 · Reduced service | $177.83 | $181.97 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $72.44 Typical High $107.15 | Professional | 53 · Discontinued | $70.79 | $72.44 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $398.11 | Professional | 54 · Surgery only | $263.03 | $275.42 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $54.95 Typical High $79.43 | Professional | 55 · Aftercare only | $53.70 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $36.31 Typical High $52.48 | Professional | 56 · Pre-op care only | $35.48 | $36.31 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $257.04 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $245.47 | $257.04 | $371.54 |
Where Tennessee sits
The same service costs 5.9 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 $6,847MT $1,164
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.