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 $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $14.13 | Professional | None | $12.88 | $12.88 | $14.13 |
Ambetter Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $30.90 | Professional | None | $22.91 | $22.91 | $30.90 |
BCBS Tennessee Setting Professional Modifier None Typical Low $17.78 Median $22.91 Typical High $22.91 | Professional | None | $17.78 | $22.91 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.98 | Facility | None | $16.22 | $16.22 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.22 | Professional | None | $12.02 | $12.02 | $16.22 |
Lucent Health Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $208.93 | Professional | None | $151.36 | $208.93 | $208.93 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $15.49 | Facility | None | $12.88 | $12.88 | $15.49 |
United Setting Professional Modifier None Typical Low $9.77 Median $14.45 Typical High $17.38 | Professional | None | $9.77 | $14.45 | $17.38 |
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 $6.46 Median $6.46 Typical High $7.08 | Professional | 52 · Reduced service | $6.46 | $6.46 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.63 Typical High $2.88 | Professional | 53 · Discontinued | $2.57 | $2.63 | $2.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $1.95 Typical High $2.14 | Professional | 55 · Aftercare only | $1.91 | $1.95 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.45 |
Where Tennessee sits
The same service costs 3.0 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· 31st of 51
$16.22
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.