How much rates vary
Facilitymedian $1,698 · 10th to 90th $513 to $4,365Professionalmedian $3,020 · 10th to 90th $2,042 to $19,498
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 $2,041.74 Median $2,187.76 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,187.76 | $2,884.03 |
BCBS Tennessee Setting Facility Modifier None Typical Low $501.19 Median $1,995.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $2,290.87 Median $3,019.95 Typical High $3,981.07 | Professional | None | $2,290.87 | $3,019.95 | $3,981.07 |
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 $2,041.74 Median $2,691.53 Typical High $3,715.35 | Professional | None | $2,041.74 | $2,691.53 | $3,715.35 |
Lucent Health Setting Professional Modifier None Typical Low $16,218.10 Median $16,218.10 Typical High $19,498.45 | Professional | None | $16,218.10 | $16,218.10 | $19,498.45 |
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 $1,778.28 Median $2,454.71 Typical High $4,570.88 | Professional | None | $1,778.28 | $2,454.71 | $4,570.88 |
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 $1,023.29 Median $1,047.13 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,023.29 | $1,047.13 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $416.87 Typical High $575.44 | Professional | 53 · Discontinued | $407.38 | $416.87 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,584.89 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,548.82 | $1,584.89 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $316.23 Typical High $436.52 | Professional | 55 · Aftercare only | $309.03 | $316.23 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $208.93 Typical High $288.40 | Professional | 56 · Pre-op care only | $204.17 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,479.11 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,479.11 | $1,995.26 |
Where Tennessee sits
The same service costs 13.8 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 $35,114TX $2,545
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.