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 $24.55 Median $52.48 Typical High $70.79 | Facility | None | $24.55 | $52.48 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $52.48 Typical High $95.50 | Professional | None | $24.55 | $52.48 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
BCBS Tennessee Setting Professional Modifier None Typical Low $28.18 Median $74.13 Typical High $100.00 | Professional | None | $28.18 | $74.13 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $89.13 | Facility | None | $75.86 | $75.86 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $60.26 Typical High $104.71 | Professional | None | $26.92 | $60.26 | $104.71 |
Lucent Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | None | $616.60 | $616.60 | $724.44 |
United Setting Professional Modifier None Typical Low $27.54 Median $66.07 Typical High $128.82 | Professional | None | $27.54 | $66.07 | $128.82 |
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 $12.30 Median $26.30 Typical High $46.77 | Professional | 52 · Reduced service | $12.30 | $26.30 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $10.72 Typical High $18.62 | Professional | 53 · Discontinued | $4.90 | $10.72 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $7.94 Typical High $13.80 | Professional | 55 · Aftercare only | $3.72 | $7.94 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $5.25 Typical High $9.33 | Professional | 56 · Pre-op care only | $2.45 | $5.25 | $9.33 |
Where Tennessee sits
The same service costs 3.6 times more in North Carolina than in Washington, DC. 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
$75.86
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.