How much rates vary
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 Professional Modifier None Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | None | $0.25 | $0.25 | $0.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.20 Median $0.21 Typical High $0.22 | Professional | None | $0.20 | $0.21 | $0.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.11 Median $0.15 Typical High $0.20 | Professional | UE · Used equipment | $0.11 | $0.15 | $0.20 |
Cigna Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.26 Median $0.46 Typical High $0.48 | Professional | None | $0.26 | $0.46 | $0.48 |
Martin's Point Setting Professional Modifier None Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | None | $0.25 | $0.25 | $0.25 |
United Setting Professional Modifier None Typical Low $0.21 Median $0.27 Typical High $0.65 | Professional | None | $0.21 | $0.27 | $0.65 |
7 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 $0.04 Median $0.04 Typical High $0.04 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
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 AW · With surgical dressing Typical Low $0.45 Median $0.45 Typical High $0.78 | Professional | AW · With surgical dressing | $0.45 | $0.45 | $0.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.04 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Martin's Point 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 |
Where Maine 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.
Maine· 48th of 51
$0.25
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.