How much rates vary
Facilitymedian $1,413 · 10th to 90th $513 to $3,890Professionalmedian $1,585 · 10th to 90th $955 to $9,550
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 $954.99 Median $954.99 Typical High $1,412.54 | Professional | None | $954.99 | $954.99 | $1,412.54 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,548.82 | $2,630.27 |
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 $1,412.54 Typical High $2,238.72 | Professional | None | $1,174.90 | $1,412.54 | $2,238.72 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $9,549.93 | Professional | None | $8,317.64 | $8,317.64 | $9,549.93 |
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 $1,047.13 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,513.56 | $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 $478.63 Median $478.63 Typical High $707.95 | Professional | 52 · Reduced service | $478.63 | $478.63 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $288.40 | Professional | 53 · Discontinued | $190.55 | $190.55 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $1,071.52 | Professional | 54 · Surgery only | $707.95 | $724.44 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $144.54 Typical High $213.80 | Professional | 55 · Aftercare only | $141.25 | $144.54 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $141.25 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $676.08 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $660.69 | $676.08 | $1,000.00 |
Where Tennessee sits
The same service costs 15.4 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 $28,500MD $1,851
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.