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 $83.18 Median $93.33 Typical High $177.83 | Facility | None | $83.18 | $93.33 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $120.23 | Professional | None | $83.18 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $48.98 Typical High $60.26 | Professional | 52 · Reduced service | $41.69 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.45 Typical High $17.78 | Professional | 55 · Aftercare only | $12.59 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.77 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.32 | $9.77 | $12.02 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $213.80 | Professional | None | $109.65 | $138.04 | $213.80 |
BCBS Tennessee Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $288.40 | Professional | None | $100.00 | $123.03 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $6,025.60 | Facility | None | $1,288.25 | $1,995.26 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $169.82 | Professional | None | $100.00 | $112.20 | $169.82 |
Lucent Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
United Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $194.98 | Professional | None | $100.00 | $117.49 | $194.98 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $81.28 Median $138.04 Typical High $208.93 | Professional | 25 · Same-day visit | $81.28 | $138.04 | $208.93 |
Where Tennessee sits
The same service costs 2.7 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
$115
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.