How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,479 to $7,762Professionalmedian $1,259 · 10th to 90th $832 to $6,918
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 $1,288.25 Median $4,073.80 Typical High $7,585.78 | Facility | None | $1,288.25 | $4,073.80 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,513.56 | Professional | None | $758.58 | $1,023.29 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,548.82 | Professional | None | $831.76 | $1,174.90 | $1,548.82 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,412.54 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,412.54 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $2,187.76 | Professional | None | $954.99 | $1,288.25 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $3,715.35 Typical High $6,760.83 | Facility | None | $1,479.11 | $3,715.35 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,905.46 | Professional | None | $831.76 | $1,000.00 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,918.31 | Professional | None | $6,456.54 | $6,456.54 | $6,918.31 |
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 $851.14 Median $1,230.27 Typical High $1,905.46 | Professional | None | $851.14 | $1,230.27 | $1,905.46 |
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 $380.19 Median $501.19 Typical High $588.84 | Professional | 52 · Reduced service | $380.19 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $204.17 Typical High $239.88 | Professional | 53 · Discontinued | $151.36 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $758.58 Typical High $891.25 | Professional | 54 · Surgery only | $575.44 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $151.36 Typical High $177.83 | Professional | 55 · Aftercare only | $114.82 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $102.33 Typical High $120.23 | Professional | 56 · Pre-op care only | $75.86 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $707.95 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $537.03 | $707.95 | $831.76 |
Where Tennessee sits
The same service costs 4.2 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 $11,551MT $2,762
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.