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 $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $22.91 Typical High $28.18 | Professional | None | $22.39 | $22.91 | $28.18 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $53.70 | Professional | None | $44.67 | $52.48 | $53.70 |
BCBS Tennessee Setting Professional Modifier None Typical Low $31.62 Median $40.74 Typical High $40.74 | Professional | None | $31.62 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $34.67 Typical High $37.15 | Facility | None | $30.20 | $34.67 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Lucent Health Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | None | $323.59 | $338.84 | $338.84 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $31.62 | Facility | None | $16.22 | $29.51 | $31.62 |
United Setting Professional Modifier None Typical Low $17.38 Median $25.12 Typical High $33.11 | Professional | None | $17.38 | $25.12 | $33.11 |
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 $11.22 Median $11.48 Typical High $13.18 | Professional | 52 · Reduced service | $11.22 | $11.48 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.57 Typical High $5.25 | Professional | 53 · Discontinued | $4.47 | $4.57 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.47 Typical High $3.98 | Professional | 55 · Aftercare only | $3.39 | $3.47 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.29 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.24 | $2.29 | $2.63 |
Where Tennessee sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 39th of 51
$30.20
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.