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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $117.49 | Professional | None | $89.13 | $91.20 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
BCBS Tennessee Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $154.88 | Professional | None | $120.23 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $117.49 | Facility | None | $112.20 | $112.20 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,513.56 | $1,513.56 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $120.23 | Professional | None | $64.57 | $97.72 | $120.23 |
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 $44.67 Median $45.71 Typical High $50.12 | Professional | 52 · Reduced service | $44.67 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.20 Typical High $19.95 | Professional | 53 · Discontinued | $17.78 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.80 Typical High $15.14 | Professional | 55 · Aftercare only | $13.49 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.12 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.91 | $9.12 | $10.00 |
Cigna Setting Professional Modifier RR · Rental Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | RR · Rental | $11.22 | $11.22 | $11.22 |
Where Tennessee sits
The same service costs 2.3 times more in Hawaii than in Delaware. 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· 46th of 51
$105
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.