How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $4Professionalmedian $0 · 10th to 90th $0 to $5
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 $0.26 Median $0.26 Typical High $0.30 | Facility | None | $0.26 | $0.26 | $0.30 |
Aetna Setting Professional Modifier None Typical Low $0.23 Median $0.27 Typical High $0.30 | Professional | None | $0.23 | $0.27 | $0.30 |
Ambetter Setting Professional Modifier None Typical Low $15.14 Median $15.85 Typical High $22.91 | Professional | None | $15.14 | $15.85 | $22.91 |
BCBS Texas Setting Facility Modifier None Typical Low $0.12 Median $0.16 Typical High $0.41 | Facility | None | $0.12 | $0.16 | $0.41 |
BCBS Texas Setting Professional Modifier None Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | None | $0.07 | $0.07 | $0.07 |
Christus Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
Cigna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | None | $0.06 | $0.06 | $0.06 |
Health Smart Setting Professional Modifier None Typical Low $0.28 Median $0.35 Typical High $0.35 | Professional | None | $0.28 | $0.35 | $0.35 |
Lucent Health Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $5.37 | Professional | None | $2.95 | $2.95 | $5.37 |
Moda Health Setting Facility Modifier None Typical Low $0.14 Median $0.26 Typical High $0.44 | Facility | None | $0.14 | $0.26 | $0.44 |
Moda Health Setting Professional Modifier None Typical Low $0.23 Median $0.27 Typical High $0.30 | Professional | None | $0.23 | $0.27 | $0.30 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Providence Setting Facility Modifier None Typical Low $0.14 Median $0.26 Typical High $0.46 | Facility | None | $0.14 | $0.26 | $0.46 |
Providence Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | None | $0.06 | $0.06 | $0.06 |
United Setting Professional Modifier None Typical Low $0.05 Median $0.07 Typical High $0.09 | Professional | None | $0.05 | $0.07 | $0.09 |
Wellpoint Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | None | $0.05 | $0.05 | $0.05 |
10 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 $0.04 Typical High $0.05 | Professional | 55 · Aftercare only | $0.03 | $0.04 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.03 | $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 |
Ambetter Setting Professional Modifier AW · With surgical dressing Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | AW · With surgical dressing | $10.00 | $10.00 | $10.00 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | Q6 · Substitute physician, paid per time | $60.26 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.04 Typical High $0.05 | Professional | 55 · Aftercare only | $0.03 | $0.04 | $0.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.03 | $0.03 |
Moda Health Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.09 Median $0.10 Typical High $0.13 | Professional | AU · Urologic/ostomy supply | $0.09 | $0.10 | $0.13 |
Moda Health Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.09 Median $0.10 Typical High $0.13 | Professional | AV · With prosthetic/orthotic | $0.09 | $0.10 | $0.13 |
Moda Health Setting Professional Modifier AW · With surgical dressing Typical Low $0.04 Median $0.04 Typical High $0.09 | Professional | AW · With surgical dressing | $0.04 | $0.04 | $0.09 |
Where Texas 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.
Texas· 26th of 51
$0.09
MN $0.36WY $0.06
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.