How much rates vary
Facilitymedian $1,413 · 10th to 90th $513 to $3,890Professionalmedian $4,898 · 10th to 90th $3,236 to $31,623
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 $2,630.27 Median $3,235.94 Typical High $7,585.78 | Facility | None | $2,630.27 | $3,235.94 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $4,786.30 | Professional | None | $3,235.94 | $3,311.31 | $4,786.30 |
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 $3,630.78 Median $4,786.30 Typical High $8,511.38 | Professional | None | $3,630.78 | $4,786.30 | $8,511.38 |
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 $3,235.94 Median $4,168.69 Typical High $6,918.31 | Professional | None | $3,235.94 | $4,168.69 | $6,918.31 |
Lucent Health Setting Professional Modifier None Typical Low $25,703.96 Median $25,703.96 Typical High $31,622.78 | Professional | None | $25,703.96 | $25,703.96 | $31,622.78 |
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 $3,311.31 Median $4,786.30 Typical High $7,762.47 | Professional | None | $3,311.31 | $4,786.30 | $7,762.47 |
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 $1,621.81 Median $1,659.59 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,621.81 | $1,659.59 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $660.69 Typical High $954.99 | Professional | 53 · Discontinued | $645.65 | $660.69 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,454.71 Typical High $3,548.13 | Professional | 54 · Surgery only | $2,398.83 | $2,454.71 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $489.78 Typical High $707.95 | Professional | 55 · Aftercare only | $489.78 | $489.78 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $331.13 Typical High $478.63 | Professional | 56 · Pre-op care only | $323.59 | $331.13 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,290.87 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,290.87 | $3,311.31 |
Where Tennessee sits
The same service costs 12.4 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 $37,371TX $3,015
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.