How much rates vary
Facilitymedian $2,951 · 10th to 90th $562 to $10,000Professionalmedian $1,778 · 10th to 90th $1,230 to $11,482
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 $1,445.44 Median $2,884.03 Typical High $7,585.78 | Facility | None | $1,445.44 | $2,884.03 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,445.44 | $2,041.74 |
Ambetter Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,122.02 | $1,778.28 |
BCBS Tennessee Setting Facility Modifier None Typical Low $2,238.72 Median $6,309.57 Typical High $12,882.50 | Facility | None | $2,238.72 | $6,309.57 | $12,882.50 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $3,548.13 | Professional | None | $1,412.54 | $1,905.46 | $3,548.13 |
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 $1,230.27 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,548.82 | $2,691.53 |
Lucent Health Setting Professional Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Professional | None | $11,481.54 | $11,481.54 | $11,481.54 |
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 $1,258.93 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,258.93 | $1,862.09 | $3,019.95 |
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 $645.65 Median $724.44 Typical High $891.25 | Professional | 52 · Reduced service | $645.65 | $724.44 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $288.40 Typical High $354.81 | Professional | 53 · Discontinued | $257.04 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,096.48 Typical High $1,348.96 | Professional | 54 · Surgery only | $977.24 | $1,096.48 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $218.78 Typical High $269.15 | Professional | 55 · Aftercare only | $194.98 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $144.54 Typical High $177.83 | Professional | 56 · Pre-op care only | $128.82 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,023.29 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $912.01 | $1,023.29 | $1,258.93 |
Where Tennessee sits
The same service costs 14.0 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 $28,122MD $2,008
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.