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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $162.18 Typical High $234.42 | Professional | None | $63.10 | $162.18 | $234.42 |
BCBS Tennessee Setting Professional Modifier None Typical Low $67.61 Median $165.96 Typical High $316.23 | Professional | None | $67.61 | $165.96 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $186.21 Typical High $199.53 | Facility | None | $169.82 | $186.21 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $151.36 Typical High $288.40 | Professional | None | $63.10 | $151.36 | $288.40 |
Lucent Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,230.27 | $1,698.24 |
United Setting Professional Modifier None Typical Low $66.07 Median $158.49 Typical High $363.08 | Professional | None | $66.07 | $158.49 | $363.08 |
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 $30.90 Median $72.44 Typical High $109.65 | Professional | 52 · Reduced service | $30.90 | $72.44 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $28.84 Typical High $43.65 | Professional | 53 · Discontinued | $12.59 | $28.84 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $109.65 Typical High $162.18 | Professional | 54 · Surgery only | $46.77 | $109.65 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $21.88 Typical High $32.36 | Professional | 55 · Aftercare only | $9.33 | $21.88 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $14.45 Typical High $21.88 | Professional | 56 · Pre-op care only | $6.31 | $14.45 | $21.88 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | GN · Speech therapy plan | $245.47 | $245.47 | $245.47 |
Where Tennessee sits
The same service costs 2.9 times more in Washington 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· 25th of 51
$178
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.