How much rates vary
Facilitymedian $2,089 · 10th to 90th $955 to $4,571Professionalmedian $1,175 · 10th to 90th $813 to $7,413
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 $1,148.15 Median $2,951.21 Typical High $7,585.78 | Facility | None | $1,148.15 | $2,951.21 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,445.44 | Professional | None | $912.01 | $1,000.00 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
BCBS Tennessee Setting Facility Modifier None Typical Low $954.99 Median $1,698.24 Typical High $3,715.35 | Facility | None | $954.99 | $1,698.24 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,548.82 | Professional | None | $891.25 | $1,023.29 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,380.38 Typical High $3,801.89 | Facility | None | $831.76 | $1,380.38 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,412.54 | Professional | None | $724.44 | $812.83 | $1,412.54 |
Lucent Health Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,413.10 | Professional | None | $7,079.46 | $7,079.46 | $7,413.10 |
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 $794.33 Median $1,000.00 Typical High $1,584.89 | Professional | None | $794.33 | $1,000.00 | $1,584.89 |
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 $457.09 Median $489.78 Typical High $691.83 | Professional | 52 · Reduced service | $457.09 | $489.78 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $275.42 | Professional | 53 · Discontinued | $181.97 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $1,023.29 | Professional | 54 · Surgery only | $691.83 | $724.44 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $204.17 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $138.04 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $954.99 |
Where Tennessee sits
The same service costs 3.1 times more in Alaska than in Maryland. 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
AK $6,735MD $2,157
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.