How much rates vary
Facilitymedian $1,413 · 10th to 90th $513 to $3,890Professionalmedian $2,138 · 10th to 90th $1,585 to $14,125
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 $1,584.89 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,584.89 | $1,737.80 | $2,398.83 |
Ambetter Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $1,621.81 Median $1,995.26 Typical High $3,548.13 | Professional | None | $1,621.81 | $1,995.26 | $3,548.13 |
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 $1,584.89 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,584.89 | $1,862.09 | $2,884.03 |
Lucent Health Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $14,125.38 | Professional | None | $12,302.69 | $12,302.69 | $14,125.38 |
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 $1,479.11 Median $1,778.28 Typical High $3,630.78 | Professional | None | $1,479.11 | $1,778.28 | $3,630.78 |
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 $794.33 Median $851.14 Typical High $1,202.26 | Professional | 52 · Reduced service | $794.33 | $851.14 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $338.84 Typical High $478.63 | Professional | 53 · Discontinued | $316.23 | $338.84 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,288.25 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,174.90 | $1,288.25 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $257.04 Typical High $354.81 | Professional | 55 · Aftercare only | $234.42 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $169.82 Typical High $239.88 | Professional | 56 · Pre-op care only | $158.49 | $169.82 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,202.26 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,202.26 | $1,659.59 |
Where Tennessee sits
The same service costs 7.6 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 $18,140MD $2,382
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.