How much rates vary
Facilitymedian $1,514 · 10th to 90th $513 to $3,981Professionalmedian $2,089 · 10th to 90th $1,413 to $17,783
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 $1,584.89 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,584.89 | $1,949.84 |
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 $1,548.82 Median $2,089.30 Typical High $3,548.13 | Professional | None | $1,548.82 | $2,089.30 | $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 $1,348.96 Median $1,698.24 Typical High $3,019.95 | Professional | None | $1,348.96 | $1,698.24 | $3,019.95 |
Lucent Health Setting Professional Modifier None Typical Low $16,595.87 Median $17,782.79 Typical High $17,782.79 | Professional | None | $16,595.87 | $17,782.79 | $17,782.79 |
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 $1,380.38 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,380.38 | $1,995.26 | $3,311.31 |
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 $794.33 Typical High $977.24 | Professional | 52 · Reduced service | $707.95 | $794.33 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $389.05 | Professional | 53 · Discontinued | $281.84 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $239.88 Typical High $295.12 | Professional | 55 · Aftercare only | $213.80 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $158.49 Typical High $194.98 | Professional | 56 · Pre-op care only | $141.25 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,122.02 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,122.02 | $1,380.38 |
Where Tennessee sits
The same service costs 11.6 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 $24,998MD $2,147
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.