How much rates vary
Facilitymedian $1,660 · 10th to 90th $794 to $4,169Professionalmedian $646 · 10th to 90th $355 to $6,310
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 $323.59 Median $602.56 Typical High $831.76 | Professional | None | $323.59 | $602.56 | $831.76 |
BCBS Tennessee Setting Facility Modifier None Typical Low $831.76 Median $1,584.89 Typical High $3,467.37 | Facility | None | $831.76 | $1,584.89 | $3,467.37 |
BCBS Tennessee Setting Professional Modifier None Typical Low $389.05 Median $645.65 Typical High $1,000.00 | Professional | None | $389.05 | $645.65 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,122.02 Typical High $2,041.74 | Facility | None | $389.05 | $1,122.02 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $676.08 Typical High $1,047.13 | Professional | None | $380.19 | $676.08 | $1,047.13 |
Lucent Health Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $9,772.37 | Professional | None | $6,309.57 | $6,309.57 | $9,772.37 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $1,096.48 | Professional | None | $323.59 | $575.44 | $1,096.48 |
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 $162.18 Median $295.12 Typical High $416.87 | Professional | 52 · Reduced service | $162.18 | $295.12 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $120.23 Typical High $165.96 | Professional | 53 · Discontinued | $64.57 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $446.68 Typical High $630.96 | Professional | 54 · Surgery only | $239.88 | $446.68 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $89.13 Typical High $125.89 | Professional | 55 · Aftercare only | $48.98 | $89.13 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $60.26 Typical High $83.18 | Professional | 56 · Pre-op care only | $32.36 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $416.87 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $223.87 | $416.87 | $588.84 |
Where Tennessee sits
The same service costs 3.2 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 $4,968MT $1,567
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.