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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $134.90 | Professional | None | $95.50 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $50.12 Typical High $67.61 | Professional | 52 · Reduced service | $47.86 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $20.42 Typical High $26.92 | Professional | 53 · Discontinued | $19.50 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.14 Typical High $19.95 | Professional | 55 · Aftercare only | $14.45 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.00 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.55 | $10.00 | $13.49 |
BCBS Tennessee Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $223.87 | Professional | None | $85.11 | $109.65 | $223.87 |
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 $77.62 Median $97.72 Typical High $144.54 | Professional | None | $77.62 | $97.72 | $144.54 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $851.14 | Professional | None | $660.69 | $660.69 | $851.14 |
United Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $181.97 | Professional | None | $69.18 | $104.71 | $181.97 |
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 GP · Physical therapy plan Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | GP · Physical therapy plan | $77.62 | $77.62 | $77.62 |
Where Tennessee sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 36th of 51
$105
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.