How much rates vary
Facilitymedian $1,660 · 10th to 90th $794 to $4,169Professionalmedian $324 · 10th to 90th $214 to $1,862
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 $245.47 Median $295.12 Typical High $407.38 | Professional | None | $245.47 | $295.12 | $407.38 |
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 $257.04 Median $323.59 Typical High $436.52 | Professional | None | $257.04 | $323.59 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $2,344.23 | Facility | None | $389.05 | $1,288.25 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $389.05 | Professional | None | $190.55 | $239.88 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $239.88 Median $302.00 Typical High $489.78 | Professional | None | $239.88 | $302.00 | $489.78 |
5 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 $123.03 Median $125.89 Typical High $181.97 | Professional | 52 · Reduced service | $123.03 | $125.89 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $50.12 Typical High $74.13 | Professional | 53 · Discontinued | $48.98 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $186.21 Typical High $275.42 | Professional | 54 · Surgery only | $181.97 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $37.15 Typical High $54.95 | Professional | 55 · Aftercare only | $36.31 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $36.31 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $36.31 |
Where Tennessee sits
The same service costs 6.4 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 $4,783MT $743
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.