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 $72.44 Median $72.44 Typical High $97.72 | Facility | None | $72.44 | $72.44 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $134.90 | Professional | None | $72.44 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $48.98 Typical High $63.10 | Professional | 52 · Reduced service | $36.31 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.79 Typical High $19.05 | Professional | 55 · Aftercare only | $10.96 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.77 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.41 | $9.77 | $12.88 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $141.25 | Professional | None | $97.72 | $125.89 | $141.25 |
BCBS Tennessee Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $181.97 | Professional | None | $93.33 | $123.03 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $154.88 | Professional | None | $89.13 | $117.49 | $154.88 |
Lucent Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Optum Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | None | $123.03 | $123.03 | $141.25 |
United Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $169.82 | Professional | None | $85.11 | $123.03 | $169.82 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $107.15 Median $125.89 Typical High $190.55 | Professional | 25 · Same-day visit | $107.15 | $125.89 | $190.55 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $58.88 Median $123.03 Typical High $123.03 | Professional | GC · Resident with teaching physician | $58.88 | $123.03 | $123.03 |
Where Tennessee sits
The same service costs 2.7 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· 31st of 51
$117
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.