How much rates vary
Facilitymedian $1,413 · 10th to 90th $513 to $3,715Professionalmedian $1,950 · 10th to 90th $1,413 to $12,882
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 $1,412.54 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,412.54 | $1,548.82 | $2,137.96 |
Ambetter Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,479.11 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,479.11 | $1,778.28 | $3,235.94 |
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 $1,513.56 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,698.24 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $12,882.50 | Professional | None | $11,220.18 | $11,220.18 | $12,882.50 |
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 $1,348.96 Median $1,659.59 Typical High $3,235.94 | Professional | None | $1,348.96 | $1,659.59 | $3,235.94 |
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 $707.95 Median $776.25 Typical High $1,071.52 | Professional | 52 · Reduced service | $707.95 | $776.25 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $309.03 Typical High $426.58 | Professional | 53 · Discontinued | $281.84 | $309.03 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,174.90 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,071.52 | $1,174.90 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $234.42 Typical High $323.59 | Professional | 55 · Aftercare only | $213.80 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $154.88 Typical High $213.80 | Professional | 56 · Pre-op care only | $141.25 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,096.48 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,096.48 | $1,513.56 |
Where Tennessee sits
The same service costs 8.1 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 $17,891MD $2,222
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.