How much rates vary
Facilitymedian $1,288 · 10th to 90th $513 to $3,715Professionalmedian $1,549 · 10th to 90th $1,148 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 $1,148.15 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,230.27 | $1,698.24 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,230.27 Typical High $3,235.94 | Facility | None | $501.19 | $1,230.27 | $3,235.94 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,288.25 | $2,344.23 |
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 $1,348.96 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,348.96 | $2,041.74 |
Lucent Health Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $10,715.19 | Professional | None | $8,912.51 | $8,912.51 | $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 $1,047.13 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,288.25 | $2,570.40 |
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 $562.34 Median $616.60 Typical High $851.14 | Professional | 52 · Reduced service | $562.34 | $616.60 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $245.47 Typical High $346.74 | Professional | 53 · Discontinued | $229.09 | $245.47 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $912.01 Typical High $1,288.25 | Professional | 54 · Surgery only | $851.14 | $912.01 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $181.97 Typical High $257.04 | Professional | 55 · Aftercare only | $169.82 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $123.03 Typical High $169.82 | Professional | 56 · Pre-op care only | $114.82 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $851.14 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $794.33 | $851.14 | $1,202.26 |
Where Tennessee sits
The same service costs 7.3 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 $13,962MD $1,911
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.