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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $208.93 | Professional | None | $151.36 | $158.49 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
BCBS Tennessee Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $331.13 | Professional | None | $190.55 | $234.42 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Lucent Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,698.24 | $1,698.24 |
United Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $380.19 | Professional | None | $158.49 | $234.42 | $380.19 |
4 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $79.43 Typical High $104.71 | Professional | 52 · Reduced service | $75.86 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $32.36 Typical High $41.69 | Professional | 53 · Discontinued | $30.20 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $31.62 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.85 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.14 | $15.85 | $20.89 |
Where Tennessee sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 20th of 51
$234
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.