How much rates vary
Facilitymedian $2,089 · 10th to 90th $525 to $5,754Professionalmedian $955 · 10th to 90th $692 to $6,310
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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,071.52 | Professional | None | $691.83 | $758.58 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,318.26 | $1,318.26 |
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 $707.95 Median $851.14 Typical High $1,548.82 | Professional | None | $707.95 | $851.14 | $1,548.82 |
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 $724.44 Median $812.83 Typical High $1,258.93 | Professional | None | $724.44 | $812.83 | $1,258.93 |
Lucent Health Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $6,309.57 | Professional | None | $5,495.41 | $5,495.41 | $6,309.57 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,456.54 | Facility | None | $1,202.26 | $3,801.89 | $6,456.54 |
United Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,584.89 | Professional | None | $691.83 | $831.76 | $1,584.89 |
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 $346.74 Median $371.54 Typical High $512.86 | Professional | 52 · Reduced service | $346.74 | $371.54 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $208.93 | Professional | 53 · Discontinued | $138.04 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $776.25 | Professional | 54 · Surgery only | $512.86 | $562.34 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $154.88 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $724.44 |
Where Tennessee sits
The same service costs 8.3 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 $16,849TX $2,029
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.