How much rates vary
Facilitymedian $1,445 · 10th to 90th $513 to $3,890Professionalmedian $1,349 · 10th to 90th $933 to $20,417
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 $933.25 Median $1,047.13 Typical High $1,288.25 | Professional | None | $933.25 | $1,047.13 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $1,023.29 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,348.96 | $2,344.23 |
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 $891.25 Median $1,122.02 Typical High $1,949.84 | Professional | None | $891.25 | $1,122.02 | $1,949.84 |
Lucent Health Setting Professional Modifier None Typical Low $9,772.37 Median $20,417.38 Typical High $20,417.38 | Professional | None | $9,772.37 | $20,417.38 | $20,417.38 |
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 $912.01 Median $1,318.26 Typical High $2,137.96 | Professional | None | $912.01 | $1,318.26 | $2,137.96 |
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 $467.74 Median $524.81 Typical High $645.65 | Professional | 52 · Reduced service | $467.74 | $524.81 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $208.93 Typical High $257.04 | Professional | 53 · Discontinued | $186.21 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $776.25 Typical High $954.99 | Professional | 54 · Surgery only | $691.83 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $154.88 Typical High $190.55 | Professional | 55 · Aftercare only | $138.04 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $104.71 Typical High $128.82 | Professional | 56 · Pre-op care only | $93.33 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $724.44 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $645.65 | $724.44 | $891.25 |
Where Tennessee sits
The same service costs 10.3 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 $16,837MD $1,634
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.