How much rates vary
Facilitymedian $1,413 · 10th to 90th $513 to $3,715Professionalmedian $2,630 · 10th to 90th $1,905 to $17,378
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 $1,905.46 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,905.46 | $2,089.30 | $2,884.03 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $3,630.78 | Facility | None | $501.19 | $1,318.26 | $3,630.78 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $4,265.80 | Professional | None | $1,995.26 | $2,398.83 | $4,265.80 |
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 $2,041.74 Median $2,238.72 Typical High $3,467.37 | Professional | None | $2,041.74 | $2,238.72 | $3,467.37 |
Lucent Health Setting Professional Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $17,378.01 | Professional | None | $15,135.61 | $15,135.61 | $17,378.01 |
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 $1,862.09 Median $2,238.72 Typical High $4,365.16 | Professional | None | $1,862.09 | $2,238.72 | $4,365.16 |
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 $954.99 Median $1,047.13 Typical High $1,445.44 | Professional | 52 · Reduced service | $954.99 | $1,047.13 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $416.87 Typical High $575.44 | Professional | 53 · Discontinued | $380.19 | $416.87 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,548.82 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,445.44 | $1,548.82 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $316.23 Typical High $436.52 | Professional | 55 · Aftercare only | $288.40 | $316.23 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $208.93 Typical High $288.40 | Professional | 56 · Pre-op care only | $190.55 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,445.44 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,445.44 | $2,041.74 |
Where Tennessee sits
The same service costs 7.6 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 $18,667TX $2,469
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.