How much rates vary
Facilitymedian $1,413 · 10th to 90th $513 to $3,890Professionalmedian $1,660 · 10th to 90th $1,096 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 $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 $1,096.48 Median $1,122.02 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,122.02 | $1,621.81 |
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 $1,258.93 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,258.93 | $1,659.59 | $2,884.03 |
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 $1,096.48 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,412.54 | $2,290.87 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $10,964.78 | Professional | None | $8,709.64 | $8,709.64 | $10,964.78 |
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 $1,148.15 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,621.81 | $2,630.27 |
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 $549.54 Median $562.34 Typical High $812.83 | Professional | 52 · Reduced service | $549.54 | $562.34 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $223.87 Typical High $323.59 | Professional | 53 · Discontinued | $218.78 | $223.87 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $1,202.26 | Professional | 54 · Surgery only | $831.76 | $851.14 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $245.47 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $112.20 Typical High $162.18 | Professional | 56 · Pre-op care only | $109.65 | $112.20 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $1,122.02 |
Where Tennessee sits
The same service costs 8.5 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 $16,489MD $1,943
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.