How much rates vary
Facilitymedian $1,413 · 10th to 90th $513 to $3,890Professionalmedian $2,138 · 10th to 90th $1,288 to $10,715
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 $1,288.25 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,348.96 | $2,137.96 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,479.11 | $1,905.46 | $3,162.28 |
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 $1,174.90 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,778.28 | $2,754.23 |
Lucent Health Setting Professional Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $10,715.19 | Professional | None | $10,471.29 | $10,471.29 | $10,715.19 |
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 $1,288.25 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,288.25 | $2,041.74 | $3,090.30 |
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 $645.65 Median $676.08 Typical High $1,071.52 | Professional | 52 · Reduced service | $645.65 | $676.08 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $275.42 Typical High $426.58 | Professional | 53 · Discontinued | $257.04 | $275.42 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,621.81 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $204.17 Typical High $323.59 | Professional | 55 · Aftercare only | $194.98 | $204.17 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $213.80 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $1,513.56 |
Where Tennessee sits
The same service costs 7.5 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 $16,075MD $2,147
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.