How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,202 to $7,244Professionalmedian $1,072 · 10th to 90th $741 to $6,026
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 $2,454.71 Median $3,090.30 Typical High $7,585.78 | Facility | None | $2,454.71 | $3,090.30 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,047.13 | Professional | None | $676.08 | $891.25 | $1,047.13 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,513.56 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,819.70 | Professional | None | $812.83 | $1,071.52 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $6,918.31 | Facility | None | $831.76 | $3,801.89 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,659.59 | Professional | None | $741.31 | $870.96 | $1,659.59 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,025.60 | Professional | None | $5,754.40 | $5,754.40 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,659.59 | Professional | None | $707.95 | $1,023.29 | $1,659.59 |
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 $338.84 Median $446.68 Typical High $524.81 | Professional | 52 · Reduced service | $338.84 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $177.83 Typical High $208.93 | Professional | 53 · Discontinued | $134.90 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $660.69 Typical High $776.25 | Professional | 54 · Surgery only | $501.19 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $134.90 Typical High $158.49 | Professional | 55 · Aftercare only | $100.00 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $89.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $67.61 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $616.60 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $467.74 | $616.60 | $724.44 |
Where Tennessee sits
The same service costs 5.3 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 $12,656MT $2,405
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.