How much rates vary
Facilitymedian $7,079 · 10th to 90th $2,570 to $17,378Professionalmedian $1,000 · 10th to 90th $603 to $11,220
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 $2,344.23 Median $5,370.32 Typical High $31,622.78 | Facility | None | $2,344.23 | $5,370.32 | $31,622.78 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $2,818.38 | Professional | None | $602.56 | $660.69 | $2,818.38 |
Ambetter Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,122.02 | Professional | None | $776.25 | $776.25 | $1,122.02 |
BCBS Tennessee Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $10,964.78 | Facility | None | $2,754.23 | $5,128.61 | $10,964.78 |
BCBS Tennessee Setting Professional Modifier None Typical Low $707.95 Median $7,413.10 Typical High $17,782.79 | Professional | None | $707.95 | $7,413.10 | $17,782.79 |
Cigna Setting Facility Modifier None Typical Low $8,709.64 Median $10,715.19 Typical High $17,782.79 | Facility | None | $8,709.64 | $10,715.19 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,348.96 | Professional | None | $588.84 | $912.01 | $1,348.96 |
Lucent Health Setting Professional Modifier None Typical Low $3,981.07 Median $5,495.41 Typical High $5,495.41 | Professional | None | $3,981.07 | $5,495.41 | $5,495.41 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,918.31 Typical High $21,877.62 | Facility | None | $1,778.28 | $6,918.31 | $21,877.62 |
United Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,445.44 | Professional | None | $630.96 | $933.25 | $1,445.44 |
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 $302.00 Median $309.03 Typical High $389.05 | Professional | 52 · Reduced service | $302.00 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $123.03 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $457.09 Typical High $588.84 | Professional | 54 · Surgery only | $446.68 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $61.66 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $61.66 | $79.43 |
Where Tennessee sits
The same service costs 9.6 times more in Oklahoma 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
OK $19,472MT $2,030
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.