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 $0.23 Median $0.31 Typical High $0.35 | Facility | None | $0.23 | $0.31 | $0.35 |
Aetna Setting Professional Modifier None Typical Low $0.23 Median $0.31 Typical High $0.35 | Professional | None | $0.23 | $0.31 | $0.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.03 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.02 | $0.03 | $0.04 |
Aetna Setting Professional Modifier AW · With surgical dressing Typical Low $0.15 Median $0.15 Typical High $0.25 | Professional | AW · With surgical dressing | $0.15 | $0.15 | $0.25 |
Ambetter Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $25.70 | Professional | None | $15.14 | $15.14 | $25.70 |
Ambetter Setting Professional Modifier AW · With surgical dressing Typical Low $38.02 Median $38.02 Typical High $40.74 | Professional | AW · With surgical dressing | $38.02 | $38.02 | $40.74 |
AvMed Setting Facility Modifier AW · With surgical dressing Typical Low $0.43 Median $0.43 Typical High $0.43 | Facility | AW · With surgical dressing | $0.43 | $0.43 | $0.43 |
AvMed Setting Professional Modifier None Typical Low $0.40 Median $0.50 Typical High $0.50 | Professional | None | $0.40 | $0.50 | $0.50 |
AvMed Setting Professional Modifier AW · With surgical dressing Typical Low $0.43 Median $0.43 Typical High $0.54 | Professional | AW · With surgical dressing | $0.43 | $0.43 | $0.54 |
Cigna Setting Facility Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Facility | None | $0.45 | $0.45 | $0.45 |
Cigna Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Florida Blue Setting Facility Modifier AW · With surgical dressing Typical Low $0.51 Median $0.51 Typical High $0.51 | Facility | AW · With surgical dressing | $0.51 | $0.51 | $0.51 |
Florida Blue Setting Professional Modifier None Typical Low $0.12 Median $0.24 Typical High $0.35 | Professional | None | $0.12 | $0.24 | $0.35 |
Florida Blue Setting Professional Modifier AW · With surgical dressing Typical Low $0.32 Median $0.32 Typical High $0.54 | Professional | AW · With surgical dressing | $0.32 | $0.32 | $0.54 |
Molina Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
United Setting Professional Modifier None Typical Low $0.24 Median $0.33 Typical High $60.26 | Professional | None | $0.24 | $0.33 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | None | $0.43 | $0.43 | $0.43 |
3 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $34.67 Median $34.67 Typical High $38.02 | Professional | AU · Urologic/ostomy supply | $34.67 | $34.67 | $38.02 |
AvMed Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.40 Median $0.40 Typical High $0.50 | Professional | AU · Urologic/ostomy supply | $0.40 | $0.40 | $0.50 |
AvMed Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.40 Median $0.40 Typical High $0.50 | Professional | AV · With prosthetic/orthotic | $0.40 | $0.40 | $0.50 |
Where Florida 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.
Florida· 26th of 51
$0.27
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.