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 Facility Modifier None Typical Low $0.15 Median $0.34 Typical High $0.34 | Facility | None | $0.15 | $0.34 | $0.34 |
Aetna Setting Professional Modifier None Typical Low $0.15 Median $0.21 Typical High $0.34 | Professional | None | $0.15 | $0.21 | $0.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.24 Median $0.36 Typical High $0.47 | Professional | None | $0.24 | $0.36 | $0.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.18 Median $0.24 Typical High $0.46 | Professional | UE · Used equipment | $0.18 | $0.24 | $0.46 |
BCBS Kansas City Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $17.78 | Professional | None | $0.62 | $0.62 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Medica Setting Facility Modifier None Typical Low $0.34 Median $0.65 Typical High $89.13 | Facility | None | $0.34 | $0.65 | $89.13 |
Medica Setting Professional Modifier None Typical Low $0.19 Median $0.34 Typical High $39.81 | Professional | None | $0.19 | $0.34 | $39.81 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.26 Typical High $0.41 | Professional | None | $0.18 | $0.26 | $0.41 |
8 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 $0.03 Typical High $0.05 | Professional | 55 · Aftercare only | $0.02 | $0.03 | $0.05 |
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 |
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 AW · With surgical dressing Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | AW · With surgical dressing | $40.74 | $40.74 | $40.74 |
Anthem BCBS Setting Professional Modifier AW · With surgical dressing Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | AW · With surgical dressing | $0.54 | $0.54 | $0.54 |
BCBS Kansas City Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.30 Median $0.30 Typical High $0.50 | Professional | AU · Urologic/ostomy supply | $0.30 | $0.30 | $0.50 |
BCBS Kansas City Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.30 Median $0.30 Typical High $0.50 | Professional | AV · With prosthetic/orthotic | $0.30 | $0.30 | $0.50 |
BCBS Kansas City 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 |
Where Missouri 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.
Missouri· 20th of 51
$0.31
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.