How much rates vary
Facilitymedian $851 · 10th to 90th $380 to $2,138Professionalmedian $178 · 10th to 90th $110 to $1,230
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 $158.49 Median $1,778.28 Typical High $6,606.93 | Facility | None | $158.49 | $1,778.28 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $223.87 | Professional | None | $107.15 | $158.49 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $380.19 Typical High $380.19 | Professional | None | $100.00 | $380.19 | $380.19 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $269.15 | Professional | None | $131.83 | $186.21 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $501.19 Typical High $1,659.59 | Facility | None | $389.05 | $501.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $269.15 | Professional | None | $104.71 | $154.88 | $269.15 |
Lucent Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,230.27 | $1,479.11 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $309.03 | Professional | None | $104.71 | $162.18 | $309.03 |
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 $53.70 Median $77.62 Typical High $112.20 | Professional | 52 · Reduced service | $53.70 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $30.90 Typical High $44.67 | Professional | 53 · Discontinued | $21.38 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $117.49 Typical High $169.82 | Professional | 54 · Surgery only | $79.43 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $23.44 Typical High $33.88 | Professional | 55 · Aftercare only | $15.85 | $23.44 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $10.72 | $15.49 | $22.39 |
Where Tennessee sits
The same service costs 6.3 times more in New York 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
NY $2,712MT $427
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.