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 $79.43 | Facility | None | $54.95 | $72.44 | $79.43 |
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 $64.57 Median $87.10 Typical High $123.03 | Professional | None | $64.57 | $87.10 | $123.03 |
BCBS Tennessee Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $181.97 | Professional | None | $70.79 | $89.13 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $77.62 Typical High $134.90 | Professional | None | $72.44 | $77.62 | $134.90 |
Lucent Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Optum Setting Professional Modifier None Typical Low $75.86 Median $77.62 Typical High $128.82 | Professional | None | $75.86 | $77.62 | $128.82 |
United Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $151.36 | Professional | None | $66.07 | $77.62 | $151.36 |
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 $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 GC · Resident with teaching physician Typical Low $70.79 Median $70.79 Typical High $134.90 | Professional | GC · Resident with teaching physician | $70.79 | $70.79 | $134.90 |
Where Tennessee sits
The same service costs 2.3 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· 37th of 51
$79.43
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.