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 $120.23 Median $154.88 Typical High $316.23 | Facility | None | $120.23 | $154.88 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $199.53 | Professional | None | $123.03 | $154.88 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $223.87 | Professional | None | $131.83 | $162.18 | $223.87 |
BCBS Tennessee Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $234.42 | Professional | None | $123.03 | $147.91 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $223.87 | Professional | None | $120.23 | $151.36 | $223.87 |
Lucent Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Optum Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $194.98 | Professional | None | $138.04 | $154.88 | $194.98 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $257.04 | Professional | None | $138.04 | $165.96 | $257.04 |
3 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 $58.88 Median $74.13 Typical High $93.33 | Professional | 52 · Reduced service | $58.88 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.39 Typical High $28.18 | Professional | 55 · Aftercare only | $17.78 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $14.79 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.02 | $14.79 | $18.62 |
Where Tennessee sits
The same service costs 2.3 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· 35th of 51
$155
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.