How much rates vary
Facilitymedian $1,175 · 10th to 90th $468 to $2,951Professionalmedian $1,698 · 10th to 90th $1,175 to $10,965
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 $1,380.38 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,380.38 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,380.38 | $1,698.24 |
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 $1,348.96 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,348.96 | $1,819.70 | $3,090.30 |
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 $1,174.90 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,479.11 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Professional | None | $10,964.78 | $10,964.78 | $10,964.78 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,737.80 | $2,884.03 |
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 $616.60 Median $691.83 Typical High $851.14 | Professional | 52 · Reduced service | $616.60 | $691.83 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $275.42 Typical High $338.84 | Professional | 53 · Discontinued | $245.47 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,047.13 Typical High $1,288.25 | Professional | 54 · Surgery only | $933.25 | $1,047.13 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $257.04 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $138.04 Typical High $169.82 | Professional | 56 · Pre-op care only | $123.03 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $977.24 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $870.96 | $977.24 | $1,202.26 |
Where Tennessee sits
The same service costs 13.1 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 $24,687MD $1,882
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.