How much rates vary
Facilitymedian $2,951 · 10th to 90th $562 to $8,710Professionalmedian $2,399 · 10th to 90th $1,622 to $15,488
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 $1,621.81 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,621.81 | $1,778.28 | $2,398.83 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,905.46 Median $5,011.87 Typical High $10,964.78 | Facility | None | $1,905.46 | $5,011.87 | $10,964.78 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $3,162.28 | Professional | None | $1,862.09 | $2,398.83 | $3,162.28 |
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 $1,621.81 Median $2,137.96 Typical High $2,951.21 | Professional | None | $1,621.81 | $2,137.96 | $2,951.21 |
Lucent Health Setting Professional Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $15,488.17 | Professional | None | $12,589.25 | $12,589.25 | $15,488.17 |
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 $1,445.44 Median $1,995.26 Typical High $3,630.78 | Professional | None | $1,445.44 | $1,995.26 | $3,630.78 |
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 $812.83 Median $831.76 Typical High $1,148.15 | Professional | 52 · Reduced service | $812.83 | $831.76 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $457.09 | Professional | 53 · Discontinued | $331.13 | $331.13 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,258.93 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,230.27 | $1,258.93 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $251.19 Typical High $346.74 | Professional | 55 · Aftercare only | $245.47 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $165.96 Typical High $229.09 | Professional | 56 · Pre-op care only | $162.18 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,174.90 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,174.90 | $1,621.81 |
Where Tennessee sits
The same service costs 14.4 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 $34,547MD $2,395
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.