How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $40
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 $0.13 Median $0.15 Typical High $0.15 | Facility | None | $0.13 | $0.15 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.13 Median $0.15 Typical High $0.21 | Professional | None | $0.13 | $0.15 | $0.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.18 Median $0.23 Typical High $0.93 | Facility | None | $0.18 | $0.23 | $0.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.20 Median $0.24 Typical High $0.36 | Professional | None | $0.20 | $0.24 | $0.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | RR · Rental | $0.24 | $0.24 | $0.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | UE · Used equipment | $0.18 | $0.18 | $0.18 |
Blue Shield Setting Facility Modifier None Typical Low $0.52 Median $0.71 Typical High $1.07 | Facility | None | $0.52 | $0.71 | $1.07 |
Blue Shield Setting Professional Modifier None Typical Low $0.62 Median $0.91 Typical High $1.45 | Professional | None | $0.62 | $0.91 | $1.45 |
Cigna Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $831.76 | Professional | None | $120.23 | $134.90 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Molina Setting Professional Modifier None Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | None | $0.66 | $0.66 | $0.66 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $0.17 Median $0.52 Typical High $0.63 | Facility | None | $0.17 | $0.52 | $0.63 |
Providence Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
United Setting Professional Modifier None Typical Low $0.22 Median $0.25 Typical High $0.59 | Professional | None | $0.22 | $0.25 | $0.59 |
16 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 $0.02 Typical High $0.03 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $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 $0.15 Median $0.17 Typical High $0.17 | Professional | AW · With surgical dressing | $0.15 | $0.17 | $0.17 |
Anthem BCBS Setting Professional Modifier AW · With surgical dressing Typical Low $0.44 Median $0.78 Typical High $0.78 | Professional | AW · With surgical dressing | $0.44 | $0.78 | $0.78 |
Kaiser Permanente Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.45 Median $0.58 Typical High $1.35 | Professional | AU · Urologic/ostomy supply | $0.45 | $0.58 | $1.35 |
Kaiser Permanente Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.45 Median $0.58 Typical High $1.35 | Professional | AV · With prosthetic/orthotic | $0.45 | $0.58 | $1.35 |
Kaiser Permanente Setting Professional Modifier AW · With surgical dressing Typical Low $0.49 Median $0.62 Typical High $1.45 | Professional | AW · With surgical dressing | $0.49 | $0.62 | $1.45 |
Providence Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.47 Median $0.48 Typical High $0.72 | Professional | AU · Urologic/ostomy supply | $0.47 | $0.48 | $0.72 |
Providence Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.47 Median $0.48 Typical High $0.72 | Professional | AV · With prosthetic/orthotic | $0.47 | $0.48 | $0.72 |
Providence Setting Professional Modifier AW · With surgical dressing Typical Low $0.51 Median $0.56 Typical High $0.79 | Professional | AW · With surgical dressing | $0.51 | $0.56 | $0.79 |
Sutter Health Plus Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.93 Median $0.93 Typical High $0.93 | Professional | AU · Urologic/ostomy supply | $0.93 | $0.93 | $0.93 |
Sutter Health Plus Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.93 Median $0.93 Typical High $0.93 | Professional | AV · With prosthetic/orthotic | $0.93 | $0.93 | $0.93 |
Sutter Health Plus Setting Professional Modifier AW · With surgical dressing Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | AW · With surgical dressing | $1.02 | $1.02 | $1.02 |
United Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | AU · Urologic/ostomy supply | $0.38 | $0.38 | $0.38 |
United Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | AV · With prosthetic/orthotic | $0.38 | $0.38 | $0.38 |
United Setting Professional Modifier AW · With surgical dressing Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | AW · With surgical dressing | $0.42 | $0.42 | $0.42 |
Where California sits
The same service costs 2.5 times more in Montana than in Colorado. 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.
California· 37th of 51
$0.26
MT $0.56CO $0.23
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.