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 $128.82 Median $169.82 Typical High $288.40 | Facility | None | $128.82 | $169.82 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $208.93 | Professional | None | $125.89 | $154.88 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $194.98 | Professional | None | $134.90 | $158.49 | $194.98 |
BCBS Tennessee Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $316.23 | Professional | None | $125.89 | $165.96 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $275.42 | Professional | None | $128.82 | $151.36 | $275.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Optum Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $186.21 | Professional | None | $131.83 | $131.83 | $186.21 |
United Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $323.59 | Professional | None | $141.25 | $177.83 | $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 $64.57 Median $75.86 Typical High $93.33 | Professional | 52 · Reduced service | $64.57 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $22.91 Typical High $28.18 | Professional | 55 · Aftercare only | $19.50 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.14 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.88 | $15.14 | $18.62 |
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· 28th of 51
$166
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.