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 $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $17.78 Typical High $23.44 | Professional | None | $13.80 | $17.78 | $23.44 |
Ambetter Setting Professional Modifier None Typical Low $18.62 Median $20.89 Typical High $43.65 | Professional | None | $18.62 | $20.89 | $43.65 |
BCBS Tennessee Setting Professional Modifier None Typical Low $19.95 Median $25.12 Typical High $52.48 | Professional | None | $19.95 | $25.12 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Lucent Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $223.87 | Professional | None | $147.91 | $147.91 | $223.87 |
United Setting Professional Modifier None Typical Low $12.88 Median $23.99 Typical High $53.70 | Professional | None | $12.88 | $23.99 | $53.70 |
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 $6.92 Median $8.91 Typical High $11.48 | Professional | 52 · Reduced service | $6.92 | $8.91 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $3.55 Typical High $4.57 | Professional | 53 · Discontinued | $2.75 | $3.55 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.69 Typical High $3.47 | Professional | 55 · Aftercare only | $2.04 | $2.69 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.78 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.38 | $1.78 | $2.29 |
Where Tennessee sits
The same service costs 4.1 times more in Wyoming 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· 41st of 51
$23.99
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.