How much rates vary
Facilitymedian $1,549 · 10th to 90th $513 to $3,981Professionalmedian $1,202 · 10th to 90th $759 to $5,495
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 $1,513.56 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,513.56 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $2,570.40 | Professional | None | $758.58 | $891.25 | $2,570.40 |
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 $851.14 Median $1,122.02 Typical High $1,862.09 | Professional | None | $851.14 | $1,122.02 | $1,862.09 |
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 $707.95 Median $1,047.13 Typical High $1,621.81 | Professional | None | $707.95 | $1,047.13 | $1,621.81 |
Lucent Health Setting Professional Modifier None Typical Low $5,495.41 Median $6,309.57 Typical High $6,309.57 | Professional | None | $5,495.41 | $6,309.57 | $6,309.57 |
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 $758.58 Median $1,202.26 Typical High $1,862.09 | Professional | None | $758.58 | $1,202.26 | $1,862.09 |
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 $380.19 Median $398.11 Typical High $630.96 | Professional | 52 · Reduced service | $380.19 | $398.11 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $251.19 | Professional | 53 · Discontinued | $151.36 | $162.18 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $954.99 | Professional | 54 · Surgery only | $575.44 | $602.56 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $190.55 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $125.89 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $891.25 |
Where Tennessee sits
The same service costs 18.7 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 $26,826MD $1,433
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.