How much rates vary
Facilitymedian $1,413 · 10th to 90th $513 to $3,890Professionalmedian $2,455 · 10th to 90th $1,778 to $16,218
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 $1,778.28 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,778.28 | $1,949.84 | $2,691.53 |
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 $1,862.09 Median $2,238.72 Typical High $3,981.07 | Professional | None | $1,862.09 | $2,238.72 | $3,981.07 |
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 $1,862.09 Median $2,089.30 Typical High $3,235.94 | Professional | None | $1,862.09 | $2,089.30 | $3,235.94 |
Lucent Health Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $16,218.10 | Professional | None | $14,125.38 | $14,125.38 | $16,218.10 |
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 $1,737.80 Median $2,089.30 Typical High $4,073.80 | Professional | None | $1,737.80 | $2,089.30 | $4,073.80 |
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 $891.25 Median $977.24 Typical High $1,348.96 | Professional | 52 · Reduced service | $891.25 | $977.24 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $537.03 | Professional | 53 · Discontinued | $354.81 | $389.05 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,445.44 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,348.96 | $1,445.44 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $288.40 Typical High $407.38 | Professional | 55 · Aftercare only | $269.15 | $288.40 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $194.98 Typical High $269.15 | Professional | 56 · Pre-op care only | $177.83 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,348.96 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,348.96 | $1,862.09 |
Where Tennessee sits
The same service costs 6.9 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 $18,419MD $2,652
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.