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 $0.50 Median $0.50 Typical High $0.50 | Facility | None | $0.50 | $0.50 | $0.50 |
Aetna Setting Professional Modifier None Typical Low $0.50 Median $0.59 Typical High $0.83 | Professional | None | $0.50 | $0.59 | $0.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.25 Median $0.30 Typical High $0.42 | Professional | 52 · Reduced service | $0.25 | $0.30 | $0.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.12 Typical High $0.17 | Professional | 53 · Discontinued | $0.10 | $0.12 | $0.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.09 Typical High $0.13 | Professional | 55 · Aftercare only | $0.08 | $0.09 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.08 |
BCBS Tennessee Setting Professional Modifier None Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | None | $0.72 | $0.72 | $0.72 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Lucent Health Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $7.24 | Professional | None | $4.79 | $4.79 | $7.24 |
United Setting Professional Modifier None Typical Low $0.27 Median $0.44 Typical High $0.48 | Professional | None | $0.27 | $0.44 | $0.48 |
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 $85.11 Median $85.11 Typical High $85.11 | Professional | A1 · Dressing, 1 wound | $85.11 | $85.11 | $85.11 |
Where Tennessee sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 34th of 51
$0.50
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.