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 $109.65 Median $165.96 Typical High $281.84 | Facility | None | $109.65 | $165.96 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $199.53 | Professional | None | $109.65 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $70.79 Typical High $95.50 | Professional | 52 · Reduced service | $54.95 | $70.79 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $295.12 | Professional | None | $120.23 | $199.53 | $295.12 |
BCBS Tennessee Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $181.97 | Professional | None | $128.82 | $165.96 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $269.15 | Professional | None | $112.20 | $177.83 | $269.15 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Optum Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $263.03 | Professional | None | $112.20 | $169.82 | $263.03 |
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 $173.78 Median $208.93 Typical High $309.03 | Professional | 25 · Same-day visit | $173.78 | $208.93 | $309.03 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | GC · Resident with teaching physician | $204.17 | $204.17 | $204.17 |
Where Tennessee sits
The same service costs 2.8 times more in Alaska than in Kentucky. 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
$162
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.