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 $66.07 Median $141.25 Typical High $141.25 | Facility | None | $66.07 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $70.79 Typical High $91.20 | Professional | None | $66.07 | $70.79 | $91.20 |
BCBS Tennessee Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $109.65 | Professional | None | $69.18 | $75.86 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $218.78 | Facility | None | $190.55 | $190.55 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $69.18 Typical High $112.20 | Professional | None | $64.57 | $69.18 | $112.20 |
Lucent Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | None | $489.78 | $489.78 | $660.69 |
United Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $123.03 | Professional | None | $64.57 | $75.86 | $123.03 |
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 $33.11 Median $34.67 Typical High $45.71 | Professional | 52 · Reduced service | $33.11 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.13 Typical High $18.62 | Professional | 53 · Discontinued | $13.18 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.47 Typical High $13.80 | Professional | 55 · Aftercare only | $9.77 | $10.47 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.08 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.61 | $7.08 | $9.12 |
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· 35th 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.