How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $4,169Professionalmedian $1,738 · 10th to 90th $1,096 to $7,943
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 $4,265.80 Typical High $7,585.78 | Facility | None | $2,344.23 | $4,265.80 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $2,818.38 | Professional | None | $1,122.02 | $1,318.26 | $2,818.38 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,584.89 Typical High $3,981.07 | Facility | None | $501.19 | $1,584.89 | $3,981.07 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,621.81 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $3,235.94 | Facility | None | $512.86 | $676.08 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,548.82 | $2,290.87 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $9,120.11 Typical High $9,120.11 | Professional | None | $7,943.28 | $9,120.11 | $9,120.11 |
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 $1,096.48 Median $1,737.80 Typical High $2,691.53 | Professional | None | $1,096.48 | $1,737.80 | $2,691.53 |
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 $562.34 Median $588.84 Typical High $933.25 | Professional | 52 · Reduced service | $562.34 | $588.84 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $371.54 | Professional | 53 · Discontinued | $223.87 | $234.42 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $891.25 Typical High $1,380.38 | Professional | 54 · Surgery only | $831.76 | $891.25 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $177.83 Typical High $275.42 | Professional | 55 · Aftercare only | $165.96 | $177.83 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $186.21 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $186.21 |
Where Tennessee sits
The same service costs 15.0 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 $27,402MD $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.