How much rates vary
Facilitymedian $2,291 · 10th to 90th $851 to $4,898Professionalmedian $661 · 10th to 90th $234 to $8,913
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 $275.42 Median $2,454.71 Typical High $6,456.54 | Facility | None | $275.42 | $2,454.71 | $6,456.54 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $436.52 Typical High $1,862.09 | Professional | None | $194.98 | $436.52 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Professional | None | $208.93 | $398.11 | $1,047.13 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,089.30 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $275.42 Median $562.34 Typical High $2,398.83 | Professional | None | $275.42 | $562.34 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $3,801.89 | Facility | None | $602.56 | $2,041.74 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $489.78 Typical High $1,949.84 | Professional | None | $213.80 | $489.78 | $1,949.84 |
Lucent Health Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $10,964.78 | Professional | None | $8,912.51 | $8,912.51 | $10,964.78 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,248.07 | Facility | None | $1,000.00 | $2,818.38 | $5,248.07 |
United Setting Professional Modifier None Typical Low $229.09 Median $478.63 Typical High $2,511.89 | Professional | None | $229.09 | $478.63 | $2,511.89 |
5 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 $97.72 Median $154.88 Typical High $851.14 | Professional | 52 · Reduced service | $97.72 | $154.88 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $63.10 Typical High $346.74 | Professional | 53 · Discontinued | $38.90 | $63.10 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $234.42 Typical High $1,288.25 | Professional | 54 · Surgery only | $147.91 | $234.42 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $46.77 Typical High $257.04 | Professional | 55 · Aftercare only | $29.51 | $46.77 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $31.62 Typical High $169.82 | Professional | 56 · Pre-op care only | $19.50 | $31.62 | $169.82 |
Where Tennessee sits
The same service costs 4.3 times more in Vermont than in Maine. 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
VT $8,043ME $1,891
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.