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 $67.61 Median $67.61 Typical High $89.13 | Facility | None | $67.61 | $67.61 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $120.23 | Professional | None | $67.61 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $44.67 Typical High $57.54 | Professional | 52 · Reduced service | $33.11 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $13.18 Typical High $16.98 | Professional | 55 · Aftercare only | $10.00 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.91 Typical High $11.48 | Professional | 56 · Pre-op care only | $6.76 | $8.91 | $11.48 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $154.88 | Professional | None | $61.66 | $114.82 | $154.88 |
BCBS Tennessee Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $165.96 | Professional | None | $85.11 | $112.20 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $141.25 | Professional | None | $81.28 | $104.71 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
United Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $154.88 | Professional | None | $75.86 | $100.00 | $154.88 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $97.72 Median $114.82 Typical High $162.18 | Professional | 25 · Same-day visit | $97.72 | $114.82 | $162.18 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $87.10 Median $112.20 Typical High $208.93 | Professional | GC · Resident with teaching physician | $87.10 | $112.20 | $208.93 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | SA · Nurse practitioner | $114.82 | $114.82 | $114.82 |
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· 29th 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.