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 $22.39 Median $38.02 Typical High $38.02 | Facility | None | $22.39 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $26.92 Typical High $38.02 | Professional | None | $22.39 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $13.49 Typical High $19.05 | Professional | 52 · Reduced service | $11.22 | $13.49 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $5.37 Typical High $7.59 | Professional | 53 · Discontinued | $4.47 | $5.37 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.98 Typical High $5.62 | Professional | 55 · Aftercare only | $3.39 | $3.98 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.69 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.24 | $2.69 | $3.80 |
BCBS Tennessee Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Lucent Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $331.13 | Professional | None | $218.78 | $218.78 | $331.13 |
United Setting Professional Modifier None Typical Low $13.80 Median $15.14 Typical High $15.14 | Professional | None | $13.80 | $15.14 | $15.14 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | A1 · Dressing, 1 wound | $38.90 | $38.90 | $38.90 |
Where Tennessee sits
The same service costs 3.2 times more in Hawaii than in Utah. 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· 25th of 51
$22.39
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.