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 $38.90 Median $87.10 Typical High $134.90 | Facility | None | $38.90 | $87.10 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $138.04 | Professional | None | $77.62 | $83.18 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $40.74 Typical High $54.95 | Professional | 52 · Reduced service | $38.90 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.60 Typical High $21.88 | Professional | 53 · Discontinued | $15.85 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.30 Typical High $16.22 | Professional | 55 · Aftercare only | $11.75 | $12.30 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.76 | $8.32 | $10.96 |
BCBS Tennessee Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $181.97 | Professional | None | $69.18 | $89.13 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $117.49 | Professional | None | $64.57 | $79.43 | $117.49 |
Lucent Health Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $707.95 | Professional | None | $537.03 | $537.03 | $707.95 |
United Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $147.91 | Professional | None | $53.70 | $85.11 | $147.91 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 59 · Distinct service | $64.57 | $64.57 | $64.57 |
Where Tennessee sits
The same service costs 2.9 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· 32nd of 51
$85.11
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.