How much rates vary
Facilitymedian $977 · 10th to 90th $447 to $2,570Professionalmedian $316 · 10th to 90th $178 to $2,188
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 $223.87 Median $1,819.70 Typical High $4,073.80 | Facility | None | $223.87 | $1,819.70 | $4,073.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $60.26 Median $123.03 Typical High $251.19 | Facility | 53 · Discontinued | $60.26 | $123.03 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $389.05 | Professional | None | $165.96 | $223.87 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $67.61 Typical High $154.88 | Professional | 53 · Discontinued | $35.48 | $67.61 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $288.40 | Professional | None | $154.88 | $194.98 | $288.40 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $549.54 | Professional | None | $190.55 | $323.59 | $549.54 |
BCBS Tennessee Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $154.88 Typical High $263.03 | Professional | 53 · Discontinued | $91.20 | $154.88 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $489.78 Typical High $2,187.76 | Facility | None | $446.68 | $489.78 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,187.76 | $3,235.94 | $3,235.94 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,570.40 | Facility | None | $346.74 | $1,047.13 | $2,570.40 |
United Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $575.44 | Professional | None | $177.83 | $309.03 | $575.44 |
4 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 $60.26 Median $93.33 Typical High $165.96 | Professional | 52 · Reduced service | $60.26 | $93.33 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $169.82 Typical High $263.03 | Professional | 54 · Surgery only | $125.89 | $169.82 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $33.88 Typical High $53.70 | Professional | 55 · Aftercare only | $25.12 | $33.88 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $22.39 Typical High $35.48 | Professional | 56 · Pre-op care only | $16.60 | $22.39 | $35.48 |
Where Tennessee sits
The same service costs 5.8 times more in Vermont than in Maine. 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
VT $4,478ME $766
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.