How much rates vary
Facilitymedian $1,549 · 10th to 90th $513 to $3,981Professionalmedian $1,585 · 10th to 90th $1,047 to $8,511
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 $1,621.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,621.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,047.13 | $1,584.89 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,548.82 Typical High $3,890.45 | Facility | None | $501.19 | $1,548.82 | $3,890.45 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,584.89 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,202.26 | $2,137.96 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,511.38 | Professional | None | $8,317.64 | $8,317.64 | $8,511.38 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,548.82 | $2,511.89 |
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 $501.19 Median $524.81 Typical High $794.33 | Professional | 52 · Reduced service | $501.19 | $524.81 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $208.93 Typical High $316.23 | Professional | 53 · Discontinued | $199.53 | $208.93 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $794.33 Typical High $1,202.26 | Professional | 54 · Surgery only | $758.58 | $794.33 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $239.88 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $104.71 Typical High $158.49 | Professional | 56 · Pre-op care only | $100.00 | $104.71 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $741.31 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $707.95 | $741.31 | $1,122.02 |
Where Tennessee sits
The same service costs 18.2 times more in Maine 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
ME $33,172MD $1,821
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.