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 $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $5.13 Typical High $7.24 | Professional | None | $4.27 | $5.13 | $7.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.14 Median $2.51 Typical High $3.63 | Professional | 52 · Reduced service | $2.14 | $2.51 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $1.02 Typical High $1.45 | Professional | 53 · Discontinued | $0.85 | $1.02 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.76 Typical High $1.07 | Professional | 55 · Aftercare only | $0.65 | $0.76 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.51 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.43 | $0.51 | $0.72 |
BCBS Tennessee Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Lucent Health Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $63.10 | Professional | None | $41.69 | $41.69 | $63.10 |
United Setting Professional Modifier None Typical Low $2.34 Median $3.80 Typical High $4.07 | Professional | None | $2.34 | $3.80 | $4.07 |
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 $7.41 Median $7.41 Typical High $7.41 | Professional | A1 · Dressing, 1 wound | $7.41 | $7.41 | $7.41 |
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· 42nd of 51
$4.27
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.