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 $0.04 Median $0.16 Typical High $0.18 | Facility | None | $0.04 | $0.16 | $0.18 |
Aetna Setting Professional Modifier None Typical Low $0.16 Median $0.18 Typical High $0.20 | Professional | None | $0.16 | $0.18 | $0.20 |
Ambetter Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $15.14 | Professional | None | $10.00 | $10.00 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | None | $0.06 | $0.06 | $0.06 |
CareSource Setting Facility Modifier None Typical Low $0.10 Median $0.28 Typical High $0.45 | Facility | None | $0.10 | $0.28 | $0.45 |
CareSource Setting Professional Modifier None Typical Low $0.14 Median $0.30 Typical High $0.39 | Professional | None | $0.14 | $0.30 | $0.39 |
Cigna Setting Facility Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Facility | None | $0.45 | $0.45 | $0.45 |
Cigna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $1.58 | Professional | None | $0.06 | $0.06 | $1.58 |
Molina Setting Professional Modifier None Typical Low $0.09 Median $0.14 Typical High $0.14 | Professional | None | $0.09 | $0.14 | $0.14 |
United Setting Professional Modifier None Typical Low $0.05 Median $0.07 Typical High $0.09 | Professional | None | $0.05 | $0.07 | $0.09 |
5 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 55 · Aftercare only Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.02 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier AW · With surgical dressing Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | AW · With surgical dressing | $0.04 | $0.04 | $0.04 |
Anthem BCBS Setting Professional Modifier AW · With surgical dressing Typical Low $0.13 Median $0.14 Typical High $0.26 | Professional | AW · With surgical dressing | $0.13 | $0.14 | $0.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.04 Median $0.05 Typical High $0.06 | Professional | UE · Used equipment | $0.04 | $0.05 | $0.06 |
Where Kentucky sits
The same service costs 6.0 times more in Minnesota than in Wyoming. 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.
Kentucky· 38th of 51
$0.07
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.