How much rates vary
Facilitymedian $1,660 · 10th to 90th $513 to $4,365Professionalmedian $1,995 · 10th to 90th $1,202 to $10,233
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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,288.25 | $1,995.26 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,995.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,819.70 | $2,951.21 |
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 $1,122.02 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,659.59 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Professional | None | $10,232.93 | $10,232.93 | $10,232.93 |
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 $1,230.27 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,230.27 | $1,905.46 | $2,951.21 |
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 $602.56 Median $645.65 Typical High $1,000.00 | Professional | 52 · Reduced service | $602.56 | $645.65 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $398.11 | Professional | 53 · Discontinued | $239.88 | $257.04 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $1,513.56 | Professional | 54 · Surgery only | $912.01 | $954.99 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $302.00 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $199.53 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $1,412.54 |
Where Tennessee sits
The same service costs 8.1 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 $15,945MD $1,975
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.