How much rates vary
Facilitymedian $1,288 · 10th to 90th $513 to $3,715Professionalmedian $1,202 · 10th to 90th $813 to $8,318
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 $812.83 Median $831.76 Typical High $1,174.90 | Professional | None | $812.83 | $831.76 | $1,174.90 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,230.27 Typical High $3,235.94 | Facility | None | $501.19 | $1,230.27 | $3,235.94 |
BCBS Tennessee Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $2,089.30 | Professional | None | $912.01 | $1,202.26 | $2,089.30 |
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 $812.83 Median $1,047.13 Typical High $1,698.24 | Professional | None | $812.83 | $1,047.13 | $1,698.24 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $8,317.64 | Professional | None | $7,413.10 | $7,413.10 | $8,317.64 |
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 $831.76 Median $1,174.90 Typical High $1,949.84 | Professional | None | $831.76 | $1,174.90 | $1,949.84 |
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 $407.38 Median $407.38 Typical High $588.84 | Professional | 52 · Reduced service | $407.38 | $407.38 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $234.42 | Professional | 53 · Discontinued | $162.18 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $891.25 | Professional | 54 · Surgery only | $602.56 | $616.60 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $123.03 Typical High $177.83 | Professional | 55 · Aftercare only | $120.23 | $123.03 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $83.18 Typical High $117.49 | Professional | 56 · Pre-op care only | $81.28 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $575.44 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $562.34 | $575.44 | $831.76 |
Where Tennessee sits
The same service costs 10.1 times more in Maine than in Arkansas. 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 $16,050AR $1,584
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.