How much rates vary
Facilitymedian $8,318 · 10th to 90th $977 to $25,704Professionalmedian $417 · 10th to 90th $288 to $8,318
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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $416.87 | Professional | None | $288.40 | $309.03 | $416.87 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,122.02 Median $7,413.10 Typical High $14,125.38 | Facility | None | $1,122.02 | $7,413.10 | $14,125.38 |
BCBS Tennessee Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $549.54 | Professional | None | $316.23 | $416.87 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $15,848.93 Typical High $29,512.09 | Facility | None | $389.05 | $15,848.93 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $512.86 | Professional | None | $288.40 | $363.08 | $512.86 |
Lucent Health Setting Professional Modifier None Typical Low $2,754.23 Median $8,317.64 Typical High $8,317.64 | Professional | None | $2,754.23 | $8,317.64 | $8,317.64 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $10,232.93 Typical High $33,113.11 | Facility | None | $3,630.78 | $10,232.93 | $33,113.11 |
United Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $630.96 | Professional | None | $245.47 | $338.84 | $630.96 |
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 $144.54 Median $147.91 Typical High $199.53 | Professional | 52 · Reduced service | $144.54 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $58.88 Typical High $81.28 | Professional | 53 · Discontinued | $57.54 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $218.78 Typical High $302.00 | Professional | 54 · Surgery only | $213.80 | $218.78 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $43.65 Typical High $60.26 | Professional | 55 · Aftercare only | $42.66 | $43.65 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $29.51 Typical High $40.74 | Professional | 56 · Pre-op care only | $28.84 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $204.17 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $199.53 | $204.17 | $281.84 |
Where Tennessee sits
The same service costs 29.1 times more in Alabama 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
AL $30,626MT $1,051
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.