How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $67.61 Median $75.86 Typical High $75.86 | Facility | None | $67.61 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $93.33 | Professional | None | $67.61 | $72.44 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $61.66 | Professional | None | $46.77 | $54.95 | $61.66 |
BCBS Tennessee Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $141.25 | Professional | None | $58.88 | $72.44 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $213.80 | Facility | None | $186.21 | $186.21 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $67.61 Typical High $112.20 | Professional | None | $66.07 | $67.61 | $112.20 |
Lucent Health Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | None | $831.76 | $851.14 | $851.14 |
United Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $144.54 | Professional | None | $63.10 | $74.13 | $144.54 |
4 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 $33.88 Median $35.48 Typical High $46.77 | Professional | 52 · Reduced service | $33.88 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.13 Typical High $18.62 | Professional | 53 · Discontinued | $13.49 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.47 Typical High $14.13 | Professional | 55 · Aftercare only | $10.00 | $10.47 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.08 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.76 | $7.08 | $9.33 |
Where Tennessee sits
The same service costs 3.2 times more in Alaska than in Florida. 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.
Tennessee· 32nd of 51
$77.62
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.