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 $0.28 Median $0.28 Typical High $0.28 | Facility | None | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier None Typical Low $0.28 Median $0.34 Typical High $0.48 | Professional | None | $0.28 | $0.34 | $0.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.15 Median $0.17 Typical High $0.24 | Professional | 52 · Reduced service | $0.15 | $0.17 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.07 Typical High $0.10 | Professional | 53 · Discontinued | $0.06 | $0.07 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.05 Typical High $0.07 | Professional | 55 · Aftercare only | $0.04 | $0.05 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.05 |
BCBS Tennessee Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | None | $0.41 | $0.41 | $0.41 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Lucent Health Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $4.17 | Professional | None | $2.75 | $2.75 | $4.17 |
United Setting Professional Modifier None Typical Low $0.16 Median $0.27 Typical High $0.28 | Professional | None | $0.16 | $0.27 | $0.28 |
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 2.6 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· 46th of 51
$0.28
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.