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 $0.21 Median $0.21 Typical High $0.21 | Facility | None | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier None Typical Low $0.20 Median $0.21 Typical High $0.21 | Professional | None | $0.20 | $0.21 | $0.21 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | None | $0.13 | $0.13 | $0.13 |
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 $0.18 Median $0.23 Typical High $0.28 | Facility | None | $0.18 | $0.23 | $0.28 |
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 $0.04 Median $0.05 Typical High $0.09 | Professional | None | $0.04 | $0.05 | $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 $0.03 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.03 | $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 |
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | A1 · Dressing, 1 wound | $12.02 | $12.02 | $12.02 |
Ambetter Setting Professional Modifier AW · With surgical dressing Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | AW · With surgical dressing | $10.96 | $10.96 | $10.96 |
Where Oklahoma 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.
Oklahoma· 42nd 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.