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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $204.17 | Professional | None | $114.82 | $120.23 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
BCBS Tennessee Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $239.88 | Professional | None | $100.00 | $125.89 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $363.08 | Facility | None | $316.23 | $316.23 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $190.55 | Professional | None | $114.82 | $114.82 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
United Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $245.47 | Professional | None | $107.15 | $123.03 | $245.47 |
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 $57.54 Median $60.26 Typical High $79.43 | Professional | 52 · Reduced service | $57.54 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.99 Typical High $31.62 | Professional | 53 · Discontinued | $22.91 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.20 Typical High $23.99 | Professional | 55 · Aftercare only | $16.98 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.02 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.48 | $12.02 | $15.85 |
Where Tennessee sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 34th of 51
$129
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.