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 $5.01 Median $5.01 Typical High $5.01 | Facility | None | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $6.03 Typical High $8.51 | Professional | None | $5.01 | $6.03 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.89 Typical High $1.29 | Professional | 55 · Aftercare only | $0.76 | $0.89 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $0.60 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.50 | $0.60 | $0.85 |
BCBS Tennessee Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
Lucent Health Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | None | $72.44 | $72.44 | $75.86 |
United Setting Professional Modifier None Typical Low $3.72 Median $5.01 Typical High $6.31 | Professional | None | $3.72 | $5.01 | $6.31 |
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 SC · Medically necessary Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | SC · Medically necessary | $5.62 | $5.62 | $5.62 |
Where Tennessee sits
The same service costs 3.2 times more in Minnesota than in Rhode Island. 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· 42nd of 51
$6.31
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.