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 $28.84 Median $40.74 Typical High $79.43 | Facility | None | $28.84 | $40.74 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $54.95 Typical High $83.18 | Professional | None | $28.84 | $54.95 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $35.48 Median $54.95 Typical High $72.44 | Professional | None | $35.48 | $54.95 | $72.44 |
BCBS Tennessee Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $112.20 | Professional | None | $41.69 | $54.95 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $46.77 Typical High $74.13 | Professional | None | $38.90 | $46.77 | $74.13 |
Lucent Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Optum Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $64.57 | Professional | None | $40.74 | $47.86 | $64.57 |
United Setting Professional Modifier None Typical Low $35.48 Median $42.66 Typical High $87.10 | Professional | None | $35.48 | $42.66 | $87.10 |
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 $14.45 Median $16.22 Typical High $19.05 | Professional | 52 · Reduced service | $14.45 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.90 Typical High $5.62 | Professional | 55 · Aftercare only | $4.37 | $4.90 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.24 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.88 | $3.24 | $3.80 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $50.12 Median $61.66 Typical High $72.44 | Professional | 25 · Same-day visit | $50.12 | $61.66 | $72.44 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $41.69 Median $52.48 Typical High $63.10 | Professional | FS · Shared visit | $41.69 | $52.48 | $63.10 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $41.69 Median $41.69 Typical High $66.07 | Professional | GC · Resident with teaching physician | $41.69 | $41.69 | $66.07 |
Where Tennessee sits
The same service costs 2.7 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· 21st of 51
$54.95
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.