How much rates vary
Facilitymedian $2,291 · 10th to 90th $513 to $8,318Professionalmedian $1,380 · 10th to 90th $1,000 to $8,913
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 $1,000.00 Median $1,071.52 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,071.52 | $1,513.56 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,445.44 Typical High $3,715.35 | Facility | None | $501.19 | $1,445.44 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,258.93 | $2,290.87 |
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 $1,047.13 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,174.90 | $1,819.70 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $8,912.51 | Professional | None | $7,943.28 | $7,943.28 | $8,912.51 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $2,290.87 | Professional | None | $977.24 | $1,174.90 | $2,290.87 |
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 $501.19 Median $537.03 Typical High $758.58 | Professional | 52 · Reduced service | $501.19 | $537.03 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $302.00 | Professional | 53 · Discontinued | $199.53 | $213.80 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $1,122.02 | Professional | 54 · Surgery only | $758.58 | $812.83 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $229.09 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $151.36 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $1,047.13 |
Where Tennessee sits
The same service costs 5.4 times more in Maine than in Texas. 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 $13,748TX $2,544
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.