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 $54.95 Median $72.44 Typical High $125.89 | Facility | None | $54.95 | $72.44 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $72.44 Typical High $107.15 | Professional | None | $56.23 | $72.44 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $131.83 | Professional | None | $57.54 | $85.11 | $131.83 |
BCBS Tennessee Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $177.83 | Professional | None | $70.79 | $87.10 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $131.83 | Professional | None | $69.18 | $75.86 | $131.83 |
Lucent Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Optum Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $89.13 | Professional | None | $74.13 | $75.86 | $89.13 |
United Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $151.36 | Professional | None | $61.66 | $75.86 | $151.36 |
8 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 $26.92 Median $29.51 Typical High $35.48 | Professional | 52 · Reduced service | $26.92 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.71 Typical High $10.72 | Professional | 55 · Aftercare only | $8.13 | $8.71 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.89 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.50 | $5.89 | $7.08 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $57.54 Median $67.61 Typical High $107.15 | Professional | 24 · Unrelated visit after surgery | $57.54 | $67.61 | $107.15 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $57.54 Median $85.11 Typical High $158.49 | Professional | 25 · Same-day visit | $57.54 | $85.11 | $158.49 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $57.54 Median $100.00 Typical High $154.88 | Professional | 57 · Decision for surgery | $57.54 | $100.00 | $154.88 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $67.61 Median $87.10 Typical High $190.55 | Professional | FS · Shared visit | $67.61 | $87.10 | $190.55 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $67.61 Median $91.20 Typical High $123.03 | Professional | GC · Resident with teaching physician | $67.61 | $91.20 | $123.03 |
Where Tennessee sits
The same service costs 2.4 times more in Alaska than in Alabama. 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· 26th of 51
$77.62
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.