How much rates vary
Facilitymedian $3,020 · 10th to 90th $912 to $7,244Professionalmedian $1,622 · 10th to 90th $1,072 to $8,710
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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,548.82 | Professional | None | $977.24 | $1,288.25 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,513.56 | $3,467.37 | $8,317.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $3,235.94 | Professional | None | $1,230.27 | $1,659.59 | $3,235.94 |
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 $1,071.52 Median $1,288.25 Typical High $2,454.71 | Professional | None | $1,071.52 | $1,288.25 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,709.64 | Professional | None | $8,317.64 | $8,317.64 | $8,709.64 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,584.89 | $2,454.71 |
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 $489.78 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $489.78 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $263.03 Typical High $309.03 | Professional | 53 · Discontinued | $194.98 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $741.31 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $147.91 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $128.82 Typical High $154.88 | Professional | 56 · Pre-op care only | $97.72 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $691.83 | $912.01 | $1,071.52 |
Where Tennessee sits
The same service costs 9.2 times more in Maine than in Texas. 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 $22,965TX $2,508
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.