How much rates vary
Facilitymedian $1,445 · 10th to 90th $513 to $3,981Professionalmedian $1,479 · 10th to 90th $977 to $7,943
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 $1,000.00 Median $1,122.02 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,122.02 | $1,380.38 |
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 $1,096.48 Median $1,479.11 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,479.11 | $2,511.89 |
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 $954.99 Median $1,202.26 Typical High $2,089.30 | Professional | None | $954.99 | $1,202.26 | $2,089.30 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,943.28 | Professional | None | $7,585.78 | $7,585.78 | $7,943.28 |
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 $977.24 Median $1,412.54 Typical High $2,344.23 | Professional | None | $977.24 | $1,412.54 | $2,344.23 |
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 $501.19 Median $562.34 Typical High $691.83 | Professional | 52 · Reduced service | $501.19 | $562.34 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $223.87 Typical High $275.42 | Professional | 53 · Discontinued | $199.53 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $851.14 Typical High $1,023.29 | Professional | 54 · Surgery only | $741.31 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $169.82 Typical High $204.17 | Professional | 55 · Aftercare only | $147.91 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $112.20 Typical High $138.04 | Professional | 56 · Pre-op care only | $100.00 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $794.33 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $691.83 | $794.33 | $954.99 |
Where Tennessee sits
The same service costs 14.5 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 $24,354MD $1,684
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.