How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,288 to $13,804Professionalmedian $2,455 · 10th to 90th $1,698 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 $1,698.24 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,698.24 | $1,819.70 | $2,454.71 |
BCBS Tennessee Setting Facility Modifier None Typical Low $2,398.83 Median $6,309.57 Typical High $12,022.64 | Facility | None | $2,398.83 | $6,309.57 | $12,022.64 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $4,570.88 | Professional | None | $1,905.46 | $2,570.40 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,122.02 Typical High $6,760.83 | Facility | None | $512.86 | $1,122.02 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,659.59 | $2,187.76 | $3,090.30 |
Lucent Health Setting Professional Modifier None Typical Low $13,182.57 Median $13,182.57 Typical High $16,218.10 | Professional | None | $13,182.57 | $13,182.57 | $16,218.10 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $10,000.00 Typical High $15,848.93 | Facility | None | $3,630.78 | $10,000.00 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,479.11 | $2,041.74 | $3,715.35 |
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 $1,174.90 | Professional | 52 · Reduced service | $831.76 | $851.14 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $467.74 | Professional | 53 · Discontinued | $338.84 | $338.84 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,288.25 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,258.93 | $1,288.25 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $257.04 Typical High $354.81 | Professional | 55 · Aftercare only | $251.19 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $234.42 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,202.26 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,202.26 | $1,659.59 |
Where Tennessee sits
The same service costs 6.9 times more in Maine than in Arkansas. 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 $34,650AR $4,993
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.