How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $0.15 Median $0.34 Typical High $0.34 | Facility | None | $0.15 | $0.34 | $0.34 |
Aetna Setting Professional Modifier None Typical Low $0.15 Median $0.21 Typical High $0.34 | Professional | None | $0.15 | $0.21 | $0.34 |
Ambetter Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.08 Median $0.17 Typical High $0.34 | Professional | None | $0.08 | $0.17 | $0.34 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.05 Median $0.08 Typical High $0.12 | Professional | UE · Used equipment | $0.05 | $0.08 | $0.12 |
BCBS Kansas City Setting Professional Modifier None Typical Low $0.06 Median $0.07 Typical High $0.15 | Professional | None | $0.06 | $0.07 | $0.15 |
Cigna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | None | $0.06 | $0.06 | $0.06 |
Medica Setting Facility Modifier None Typical Low $0.17 Median $0.51 Typical High $89.13 | Facility | None | $0.17 | $0.51 | $89.13 |
Medica Setting Professional Modifier None Typical Low $0.05 Median $0.09 Typical High $5.37 | Professional | None | $0.05 | $0.09 | $5.37 |
United Setting Professional Modifier None Typical Low $0.05 Median $0.07 Typical High $0.11 | Professional | None | $0.05 | $0.07 | $0.11 |
6 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 $0.05 | Professional | 55 · Aftercare only | $0.02 | $0.03 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.03 |
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 |
BCBS Kansas City Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.06 Median $0.06 Typical High $0.10 | Professional | AU · Urologic/ostomy supply | $0.06 | $0.06 | $0.10 |
BCBS Kansas City Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.06 Median $0.06 Typical High $0.10 | Professional | AV · With prosthetic/orthotic | $0.06 | $0.06 | $0.10 |
BCBS Kansas City Setting Professional Modifier AW · With surgical dressing Typical Low $0.08 Median $0.08 Typical High $0.14 | Professional | AW · With surgical dressing | $0.08 | $0.08 | $0.14 |
Where Missouri 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.
Missouri· 32nd of 51
$0.08
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.