How much rates vary
Facilitymedian $2,570 · 10th to 90th $575 to $7,943Professionalmedian $1,585 · 10th to 90th $955 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 $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 $954.99 Median $1,202.26 Typical High $2,089.30 | Professional | None | $954.99 | $1,202.26 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $812.83 Median $1,737.80 Typical High $1,995.26 | Professional | None | $812.83 | $1,737.80 | $1,995.26 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,318.26 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $31,622.78 | Professional | None | $1,122.02 | $1,737.80 | $31,622.78 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $812.83 Typical High $10,715.19 | Facility | None | $512.86 | $812.83 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $1,995.26 | Professional | None | $870.96 | $1,318.26 | $1,995.26 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Professional | None | $7,943.28 | $7,943.28 | $7,943.28 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $4,365.16 | Facility | None | $501.19 | $1,778.28 | $4,365.16 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,548.82 Typical High $2,290.87 | Professional | None | $954.99 | $1,548.82 | $2,290.87 |
4 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 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $1,174.90 | Professional | 54 · Surgery only | $707.95 | $758.58 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $234.42 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $158.49 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $1,096.48 |
Where Tennessee sits
The same service costs 9.4 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 $15,900MD $1,684
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.