How much rates vary
Facilitymedian $1,514 · 10th to 90th $513 to $3,981Professionalmedian $2,512 · 10th to 90th $1,660 to $16,218
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 $1,659.59 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,659.59 | $1,698.24 | $2,454.71 |
Ambetter Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,548.82 Typical High $3,890.45 | Facility | None | $501.19 | $1,548.82 | $3,890.45 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,905.46 Median $2,511.89 Typical High $4,365.16 | Professional | None | $1,905.46 | $2,511.89 | $4,365.16 |
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 $1,659.59 Median $2,137.96 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,137.96 | $3,467.37 |
Lucent Health Setting Professional Modifier None Typical Low $15,848.93 Median $15,848.93 Typical High $16,218.10 | Professional | None | $15,848.93 | $15,848.93 | $16,218.10 |
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 $1,698.24 Median $2,454.71 Typical High $3,981.07 | Professional | None | $1,698.24 | $2,454.71 | $3,981.07 |
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 $831.76 Median $851.14 Typical High $1,230.27 | Professional | 52 · Reduced service | $831.76 | $851.14 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $489.78 | Professional | 53 · Discontinued | $331.13 | $338.84 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,288.25 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,258.93 | $1,288.25 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $257.04 Typical High $363.08 | Professional | 55 · Aftercare only | $251.19 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $245.47 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,202.26 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,202.26 | $1,698.24 |
Where Tennessee sits
The same service costs 13.4 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 $34,930MD $2,604
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.