How much rates vary
Facilitymedian $1,778 · 10th to 90th $832 to $4,169Professionalmedian $407 · 10th to 90th $214 to $2,818
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 $524.81 Median $2,137.96 Typical High $7,585.78 | Facility | None | $524.81 | $2,137.96 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $575.44 | Professional | None | $208.93 | $389.05 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $398.11 Typical High $758.58 | Professional | None | $162.18 | $398.11 | $758.58 |
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 $263.03 Median $426.58 Typical High $645.65 | Professional | None | $263.03 | $426.58 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,202.26 Typical High $3,801.89 | Facility | None | $707.95 | $1,202.26 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $407.38 Typical High $630.96 | Professional | None | $177.83 | $407.38 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,162.28 | $3,981.07 | $3,981.07 |
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 $208.93 Median $389.05 Typical High $741.31 | Professional | None | $208.93 | $389.05 | $741.31 |
7 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 $104.71 Median $173.78 Typical High $275.42 | Professional | 52 · Reduced service | $104.71 | $173.78 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $69.18 Typical High $109.65 | Professional | 53 · Discontinued | $41.69 | $69.18 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $257.04 Typical High $416.87 | Professional | 54 · Surgery only | $154.88 | $257.04 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $52.48 Typical High $83.18 | Professional | 55 · Aftercare only | $31.62 | $52.48 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $34.67 Typical High $54.95 | Professional | 56 · Pre-op care only | $20.89 | $34.67 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $239.88 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $144.54 | $239.88 | $389.05 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $645.65 Typical High $1,122.02 | Professional | 50 · Both sides | $229.09 | $645.65 | $1,122.02 |
Where Tennessee sits
The same service costs 4.6 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 $4,720MT $1,020
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.