How much rates vary
Facilitymedian $10,715 · 10th to 90th $1,288 to $34,674Professionalmedian $724 · 10th to 90th $479 to $13,490
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 $2,630.27 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,630.27 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $1,023.29 | Professional | None | $467.74 | $537.03 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,288.25 Median $8,317.64 Typical High $21,379.62 | Facility | None | $1,288.25 | $8,317.64 | $21,379.62 |
BCBS Tennessee Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $1,258.93 | Professional | None | $537.03 | $724.44 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $33,113.11 Typical High $50,118.72 | Facility | None | $524.81 | $33,113.11 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,000.00 | Professional | None | $478.63 | $616.60 | $1,000.00 |
Lucent Health Setting Professional Modifier None Typical Low $5,011.87 Median $13,489.63 Typical High $13,489.63 | Professional | None | $5,011.87 | $13,489.63 | $13,489.63 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $14,791.08 Typical High $30,902.95 | Facility | None | $5,888.44 | $14,791.08 | $30,902.95 |
United Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,148.15 | Professional | None | $478.63 | $691.83 | $1,148.15 |
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 $234.42 Median $239.88 Typical High $346.74 | Professional | 52 · Reduced service | $234.42 | $239.88 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $138.04 | Professional | 53 · Discontinued | $93.33 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $512.86 | Professional | 54 · Surgery only | $354.81 | $363.08 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $102.33 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $69.18 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $338.84 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $331.13 | $338.84 | $478.63 |
Where Tennessee sits
The same service costs 24.6 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 $43,875MT $1,787
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.