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 $0.28 Median $0.28 Typical High $0.28 | Facility | None | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier None Typical Low $0.17 Median $0.28 Typical High $0.28 | Professional | None | $0.17 | $0.28 | $0.28 |
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 |
Ambetter Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $23.99 | Professional | None | $21.88 | $21.88 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.24 Median $0.24 Typical High $0.46 | Facility | None | $0.24 | $0.24 | $0.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.24 Median $0.31 Typical High $0.45 | Professional | None | $0.24 | $0.31 | $0.45 |
Anthem BCBS Setting Professional Modifier AW · With surgical dressing Typical Low $0.44 Median $0.44 Typical High $0.59 | Professional | AW · With surgical dressing | $0.44 | $0.44 | $0.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.18 Median $0.24 Typical High $0.24 | Professional | UE · Used equipment | $0.18 | $0.24 | $0.24 |
CareSource Setting Facility Modifier None Typical Low $0.71 Median $0.74 Typical High $0.79 | Facility | None | $0.71 | $0.74 | $0.79 |
CareSource Setting Professional Modifier None Typical Low $0.30 Median $0.35 Typical High $0.42 | Professional | None | $0.30 | $0.35 | $0.42 |
Cigna Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $1.58 | Professional | None | $0.26 | $0.26 | $1.58 |
Cigna Setting Professional Modifier AW · With surgical dressing Typical Low $0.58 Median $0.58 Typical High $0.63 | Professional | AW · With surgical dressing | $0.58 | $0.58 | $0.63 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,290.87 | Facility | None | $912.01 | $2,089.30 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.07 Median $0.30 Typical High $245.47 | Professional | None | $0.07 | $0.30 | $245.47 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier AW · With surgical dressing Typical Low $0.33 Median $0.50 Typical High $0.83 | Professional | AW · With surgical dressing | $0.33 | $0.50 | $0.83 |
United Setting Professional Modifier None Typical Low $0.15 Median $0.27 Typical High $0.45 | Professional | None | $0.15 | $0.27 | $0.45 |
2 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 $0.04 | Professional | 55 · Aftercare only | $0.03 | $0.04 | $0.04 |
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 |
Where Indiana 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.
Indiana· 31st 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.