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 $91.20 Median $194.98 Typical High $194.98 | Facility | None | $91.20 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $128.82 | Professional | None | $91.20 | $97.72 | $128.82 |
BCBS Tennessee Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $154.88 | Professional | None | $95.50 | $104.71 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $295.12 | Facility | None | $257.04 | $257.04 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $95.50 Typical High $151.36 | Professional | None | $91.20 | $95.50 | $151.36 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $3,162.28 Typical High $3,162.28 | Professional | None | $912.01 | $3,162.28 | $3,162.28 |
United Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $162.18 | Professional | None | $85.11 | $100.00 | $162.18 |
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 $45.71 Median $48.98 Typical High $64.57 | Professional | 52 · Reduced service | $45.71 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.50 Typical High $25.70 | Professional | 53 · Discontinued | $18.20 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.79 Typical High $19.05 | Professional | 55 · Aftercare only | $13.80 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.77 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.12 | $9.77 | $12.88 |
Where Tennessee sits
The same service costs 3.0 times more in Alaska than in Florida. 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
$117
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.