How much rates vary
Facilitymedian $1,514 · 10th to 90th $513 to $3,981Professionalmedian $1,096 · 10th to 90th $794 to $7,413
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 $794.33 Median $870.96 Typical High $1,202.26 | Professional | None | $794.33 | $870.96 | $1,202.26 |
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 $812.83 Median $1,000.00 Typical High $1,778.28 | Professional | None | $812.83 | $1,000.00 | $1,778.28 |
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 $831.76 Median $933.25 Typical High $1,445.44 | Professional | None | $831.76 | $933.25 | $1,445.44 |
Lucent Health Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $7,413.10 | Professional | None | $6,309.57 | $6,309.57 | $7,413.10 |
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 $758.58 Median $912.01 Typical High $1,819.70 | Professional | None | $758.58 | $912.01 | $1,819.70 |
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 $398.11 Median $436.52 Typical High $588.84 | Professional | 52 · Reduced service | $398.11 | $436.52 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $239.88 | Professional | 53 · Discontinued | $158.49 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $891.25 | Professional | 54 · Surgery only | $588.84 | $645.65 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $177.83 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $120.23 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $831.76 |
Where Tennessee sits
The same service costs 11.4 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 $16,997MD $1,496
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.