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 $0.15 Median $0.15 Typical High $0.15 | Facility | None | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.15 Median $0.15 Typical High $0.27 | Professional | None | $0.15 | $0.15 | $0.27 |
Aetna Setting Professional Modifier AW · With surgical dressing Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | AW · With surgical dressing | $0.15 | $0.15 | $0.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.20 Median $0.21 Typical High $0.40 | Professional | None | $0.20 | $0.21 | $0.40 |
Cigna Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Denver HMP Setting Facility Modifier None Typical Low $0.15 Median $0.26 Typical High $0.56 | Facility | None | $0.15 | $0.26 | $0.56 |
Denver HMP Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $346.74 | Professional | None | $1.00 | $1.00 | $346.74 |
Kaiser Permanente Setting Professional Modifier AW · With surgical dressing Typical Low $0.54 Median $0.71 Typical High $1.02 | Professional | AW · With surgical dressing | $0.54 | $0.71 | $1.02 |
Select Health Setting Facility Modifier None Typical Low $0.50 Median $0.93 Typical High $1.05 | Facility | None | $0.50 | $0.93 | $1.05 |
Select Health Setting Professional Modifier None Typical Low $0.44 Median $0.49 Typical High $0.87 | Professional | None | $0.44 | $0.49 | $0.87 |
United Setting Professional Modifier None Typical Low $0.22 Median $0.23 Typical High $0.34 | Professional | None | $0.22 | $0.23 | $0.34 |
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 $0.02 Typical High $0.04 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.04 |
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 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.15 Median $0.19 Typical High $0.36 | Professional | UE · Used equipment | $0.15 | $0.19 | $0.36 |
Kaiser Permanente Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.50 Median $0.66 Typical High $0.95 | Professional | AU · Urologic/ostomy supply | $0.50 | $0.66 | $0.95 |
Kaiser Permanente Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.50 Median $0.66 Typical High $0.95 | Professional | AV · With prosthetic/orthotic | $0.50 | $0.66 | $0.95 |
Where Colorado 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.
Colorado· 51st of 51
$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.