How much rates vary
Facilitymedian $1,660 · 10th to 90th $794 to $4,169Professionalmedian $447 · 10th to 90th $324 to $4,266
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 $363.08 Typical High $478.63 | Professional | None | $323.59 | $363.08 | $478.63 |
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 $354.81 Median $489.78 Typical High $630.96 | Professional | None | $354.81 | $489.78 | $630.96 |
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 $338.84 Median $426.58 Typical High $602.56 | Professional | None | $338.84 | $426.58 | $602.56 |
Lucent Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
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 $288.40 Median $389.05 Typical High $741.31 | Professional | None | $288.40 | $389.05 | $741.31 |
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 $169.82 Typical High $229.09 | Professional | 52 · Reduced service | $162.18 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $91.20 | Professional | 53 · Discontinued | $66.07 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $257.04 Typical High $346.74 | Professional | 54 · Surgery only | $245.47 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $69.18 | Professional | 55 · Aftercare only | $48.98 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.88 Typical High $45.71 | Professional | 56 · Pre-op care only | $32.36 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $239.88 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $229.09 | $239.88 | $323.59 |
Where Tennessee sits
The same service costs 4.0 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 $4,866MT $1,221
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.