How much rates vary
Facilitymedian $2,399 · 10th to 90th $977 to $5,012Professionalmedian $759 · 10th to 90th $513 to $4,266
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 $1,071.52 Median $2,951.21 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,951.21 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $1,000.00 | Professional | None | $489.78 | $645.65 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $912.01 | Professional | None | $602.56 | $602.56 | $912.01 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $5,128.61 | Facility | None | $1,122.02 | $2,137.96 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,288.25 | Professional | None | $562.34 | $758.58 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,137.96 Typical High $3,801.89 | Facility | None | $831.76 | $2,137.96 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $1,148.15 | Professional | None | $524.81 | $645.65 | $1,148.15 |
Lucent Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,786.30 | Professional | None | $4,265.80 | $4,265.80 | $4,786.30 |
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 $501.19 Median $707.95 Typical High $1,174.90 | Professional | None | $501.19 | $707.95 | $1,174.90 |
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 $239.88 Median $323.59 Typical High $380.19 | Professional | 52 · Reduced service | $239.88 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $128.82 Typical High $151.36 | Professional | 53 · Discontinued | $97.72 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $478.63 Typical High $562.34 | Professional | 54 · Surgery only | $363.08 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $95.50 Typical High $112.20 | Professional | 55 · Aftercare only | $72.44 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $64.57 Typical High $75.86 | Professional | 56 · Pre-op care only | $48.98 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $446.68 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $338.84 | $446.68 | $524.81 |
Where Tennessee sits
The same service costs 3.6 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 $6,446MT $1,806
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.