How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,230 to $7,413Professionalmedian $1,023 · 10th to 90th $692 to $6,761
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 $1,000.00 Median $2,951.21 Typical High $7,585.78 | Facility | None | $1,000.00 | $2,951.21 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,380.38 | Professional | None | $630.96 | $851.14 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $794.33 Typical High $1,122.02 | Professional | None | $416.87 | $794.33 | $1,122.02 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,288.25 Median $2,884.03 Typical High $6,309.57 | Facility | None | $1,288.25 | $2,884.03 | $6,309.57 |
BCBS Tennessee Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,698.24 | Professional | None | $776.25 | $1,023.29 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,467.37 Typical High $6,456.54 | Facility | None | $831.76 | $3,467.37 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,548.82 | Professional | None | $691.83 | $831.76 | $1,548.82 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $6,760.83 Typical High $6,760.83 | Professional | None | $5,754.40 | $6,760.83 | $6,760.83 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,570.88 | $9,772.37 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,548.82 | Professional | None | $691.83 | $1,000.00 | $1,548.82 |
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 $316.23 Median $416.87 Typical High $489.78 | Professional | 52 · Reduced service | $316.23 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $165.96 Typical High $194.98 | Professional | 53 · Discontinued | $125.89 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $630.96 Typical High $741.31 | Professional | 54 · Surgery only | $467.74 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $125.89 Typical High $147.91 | Professional | 55 · Aftercare only | $95.50 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $63.10 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $588.84 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $436.52 | $588.84 | $691.83 |
Where Tennessee sits
The same service costs 4.5 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 $10,099MT $2,245
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.