How much rates vary
Facilitymedian $1,445 · 10th to 90th $513 to $3,981Professionalmedian $1,950 · 10th to 90th $1,349 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 $1,348.96 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,513.56 | $1,862.09 |
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 $1,479.11 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,479.11 | $1,949.84 | $3,388.44 |
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 $1,288.25 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,584.89 | $2,818.38 |
Lucent Health Setting Professional Modifier None Typical Low $11,481.54 Median $12,882.50 Typical High $12,882.50 | Professional | None | $11,481.54 | $12,882.50 | $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 $1,288.25 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,288.25 | $1,905.46 | $3,090.30 |
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 $660.69 Median $758.58 Typical High $933.25 | Professional | 52 · Reduced service | $660.69 | $758.58 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $302.00 Typical High $371.54 | Professional | 53 · Discontinued | $269.15 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $223.87 Typical High $275.42 | Professional | 55 · Aftercare only | $199.53 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $151.36 Typical High $186.21 | Professional | 56 · Pre-op care only | $134.90 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,288.25 |
Where Tennessee sits
The same service costs 12.0 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 $24,859MD $2,076
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.