How much rates vary
Facilitymedian $2,291 · 10th to 90th $525 to $8,318Professionalmedian $1,738 · 10th to 90th $1,175 to $12,023
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 $1,995.26 Median $4,265.80 Typical High $7,585.78 | Facility | None | $1,995.26 | $4,265.80 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,202.26 | $1,995.26 |
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 $1,348.96 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,348.96 | $1,778.28 | $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 $1,513.56 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,513.56 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $12,022.64 Median $12,022.64 Typical High $12,022.64 | Professional | None | $12,022.64 | $12,022.64 | $12,022.64 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,737.80 | $2,818.38 |
7 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 $588.84 Median $602.56 Typical High $870.96 | Professional | 52 · Reduced service | $588.84 | $602.56 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $346.74 | Professional | 53 · Discontinued | $234.42 | $239.88 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $1,288.25 | Professional | 54 · Surgery only | $891.25 | $912.01 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $257.04 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $173.78 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $1,202.26 |
Ambetter Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | AS · PA/NP assist | $257.04 | $257.04 | $257.04 |
Where Tennessee sits
The same service costs 13.5 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 $34,179TX $2,531
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.