How much rates vary
Facilitymedian $2,291 · 10th to 90th $525 to $6,607Professionalmedian $1,698 · 10th to 90th $1,230 to $11,220
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 $3,981.07 Typical High $7,585.78 | Facility | None | $2,454.71 | $3,981.07 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,380.38 | $1,905.46 |
Ambetter Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,380.38 | $1,862.09 |
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 $1,288.25 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,548.82 | $2,884.03 |
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 $1,318.26 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,445.44 | $2,238.72 |
Lucent Health Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $11,220.18 | Professional | None | $9,772.37 | $9,772.37 | $11,220.18 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,513.56 | $2,818.38 |
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 $616.60 Median $676.08 Typical High $933.25 | Professional | 52 · Reduced service | $616.60 | $676.08 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $269.15 Typical High $371.54 | Professional | 53 · Discontinued | $245.47 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,000.00 Typical High $1,412.54 | Professional | 54 · Surgery only | $933.25 | $1,000.00 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $281.84 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $186.21 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $933.25 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $870.96 | $933.25 | $1,318.26 |
Where Tennessee sits
The same service costs 8.5 times more in Maine than in Delaware. 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 $28,081DE $3,299
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.