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 $93.33 Median $93.33 Typical High $138.04 | Facility | None | $93.33 | $93.33 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $85.11 Typical High $95.50 | Professional | None | $37.15 | $85.11 | $95.50 |
BCBS Tennessee Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $165.96 | Professional | None | $79.43 | $89.13 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Lucent Health Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $831.76 | Professional | None | $602.56 | $831.76 | $831.76 |
United Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $141.25 | Professional | None | $74.13 | $87.10 | $141.25 |
5 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 $46.77 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $9.33 |
Ambetter Setting Professional Modifier CG · Policy criteria applied Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | CG · Policy criteria applied | $77.62 | $77.62 | $77.62 |
Where Tennessee sits
The same service costs 3.3 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· 28th of 51
$93.33
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.