How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $125.89 | Professional | None | $64.57 | $67.61 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $147.91 | Professional | None | $102.33 | $125.89 | $147.91 |
BCBS Tennessee Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | None | $87.10 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $102.33 | Facility | None | $97.72 | $97.72 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Lucent Health Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $1,258.93 | Professional | None | $870.96 | $1,258.93 | $1,258.93 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $89.13 | Facility | None | $79.43 | $79.43 | $89.13 |
United Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $93.33 | Professional | None | $48.98 | $70.79 | $93.33 |
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 $32.36 Median $33.11 Typical High $42.66 | Professional | 52 · Reduced service | $32.36 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.18 Typical High $16.98 | Professional | 53 · Discontinued | $12.88 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $12.88 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.61 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.46 | $6.61 | $8.51 |
Where Tennessee sits
The same service costs 2.8 times more in Hawaii than in Florida. 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· 43rd of 51
$87.10
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.