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 $147.91 Median $199.53 Typical High $380.19 | Facility | None | $147.91 | $199.53 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $245.47 | Professional | None | $158.49 | $194.98 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $398.11 | Professional | None | $194.98 | $213.80 | $398.11 |
BCBS Tennessee Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $309.03 | Professional | None | $165.96 | $199.53 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $281.84 | Professional | None | $158.49 | $199.53 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Optum Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $234.42 | Professional | None | $169.82 | $204.17 | $234.42 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $323.59 | Professional | None | $173.78 | $208.93 | $323.59 |
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 $74.13 Median $93.33 Typical High $114.82 | Professional | 52 · Reduced service | $74.13 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $27.54 Typical High $33.88 | Professional | 55 · Aftercare only | $21.88 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $18.62 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.79 | $18.62 | $22.91 |
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· 32nd of 51
$200
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.