How much rates vary
Facilitymedian $44 · 10th to 90th $29 to $151Professionalmedian $42 · 10th to 90th $26 to $74
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $28.84 Median $38.90 Typical High $63.10 | Facility | None | $28.84 | $38.90 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $41.69 Typical High $51.29 | Professional | None | $27.54 | $41.69 | $51.29 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $54.95 Typical High $81.28 | Professional | None | $25.12 | $54.95 | $81.28 |
BCBS Tennessee Setting Professional Modifier None Typical Low $25.70 Median $40.74 Typical High $67.61 | Professional | None | $25.70 | $40.74 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $208.93 | Facility | None | $109.65 | $141.25 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $56.23 | Professional | None | $30.90 | $41.69 | $56.23 |
Lucent Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Optum Setting Professional Modifier None Typical Low $46.77 Median $53.70 Typical High $58.88 | Professional | None | $46.77 | $53.70 | $58.88 |
United Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
United Setting Professional Modifier None Typical Low $23.99 Median $38.90 Typical High $57.54 | Professional | None | $23.99 | $38.90 | $57.54 |
10 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 $13.80 Median $17.78 Typical High $25.70 | Professional | 52 · Reduced service | $13.80 | $17.78 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $5.37 Typical High $7.76 | Professional | 55 · Aftercare only | $4.07 | $5.37 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $3.55 Typical High $5.13 | Professional | 56 · Pre-op care only | $2.75 | $3.55 | $5.13 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $42.66 Median $54.95 Typical High $75.86 | Professional | 25 · Same-day visit | $42.66 | $54.95 | $75.86 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 33 · Preventive service | $25.12 | $25.12 | $25.12 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 57 · Decision for surgery | $48.98 | $48.98 | $48.98 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $29.51 Median $50.12 Typical High $77.62 | Professional | 93 · Audio-only telehealth | $29.51 | $50.12 | $77.62 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $29.51 Median $74.13 Typical High $75.86 | Professional | GC · Resident with teaching physician | $29.51 | $74.13 | $75.86 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | GE · Resident, primary care exception | $39.81 | $39.81 | $39.81 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | Q6 · Substitute physician, paid per time | $83.18 | $83.18 | $83.18 |
Where Tennessee sits
The same service costs 2.4 times more in Alaska than in New Jersey. 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· 33rd of 51
$41.69
AK $77.62NJ $32.36
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.