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 $64.57 Median $64.57 Typical High $89.13 | Facility | None | $64.57 | $64.57 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $123.03 | Professional | None | $64.57 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $44.67 Typical High $57.54 | Professional | 52 · Reduced service | $32.36 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.49 Typical High $17.38 | Professional | 55 · Aftercare only | $9.77 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.91 Typical High $11.48 | Professional | 56 · Pre-op care only | $6.46 | $8.91 | $11.48 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $147.91 | Professional | None | $100.00 | $117.49 | $147.91 |
BCBS Tennessee Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $165.96 | Professional | None | $83.18 | $112.20 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $141.25 | Professional | None | $77.62 | $104.71 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Optum Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | None | $112.20 | $112.20 | $128.82 |
United Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $147.91 | Professional | None | $75.86 | $109.65 | $147.91 |
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 $100.00 Median $117.49 Typical High $144.54 | Professional | 25 · Same-day visit | $100.00 | $117.49 | $144.54 |
Where Tennessee sits
The same service costs 2.8 times more in Alaska than in Washington, DC. 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· 34th of 51
$107
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.