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 $0.30 Median $0.30 Typical High $0.30 | Facility | None | $0.30 | $0.30 | $0.30 |
Aetna Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | None | $0.30 | $0.30 | $0.30 |
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 |
BCBS Nebraska Setting Professional Modifier None Typical Low $0.50 Median $0.52 Typical High $0.52 | Professional | None | $0.50 | $0.52 | $0.52 |
Cigna Setting Professional Modifier None Typical Low $0.38 Median $0.58 Typical High $0.85 | Professional | None | $0.38 | $0.58 | $0.85 |
Cigna Setting Professional Modifier AW · With surgical dressing Typical Low $0.58 Median $0.59 Typical High $1.15 | Professional | AW · With surgical dressing | $0.58 | $0.59 | $1.15 |
Medica Setting Facility Modifier None Typical Low $0.27 Median $1.00 Typical High $89.13 | Facility | None | $0.27 | $1.00 | $89.13 |
Medica Setting Professional Modifier None Typical Low $0.20 Median $0.27 Typical High $39.81 | Professional | None | $0.20 | $0.27 | $39.81 |
Midlands Setting Professional Modifier None Typical Low $0.38 Median $0.85 Typical High $0.85 | Professional | None | $0.38 | $0.85 | $0.85 |
Midlands Setting Professional Modifier AW · With surgical dressing Typical Low $0.58 Median $0.58 Typical High $1.45 | Professional | AW · With surgical dressing | $0.58 | $0.58 | $1.45 |
Midlands Setting Professional Modifier None Typical Low $0.38 Median $0.85 Typical High $0.85 | Professional | None | $0.38 | $0.85 | $0.85 |
United Setting Professional Modifier None Typical Low $0.19 Median $0.26 Typical High $0.42 | Professional | None | $0.19 | $0.26 | $0.42 |
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 $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
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 |
Where Nebraska 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.
Nebraska· 4th of 51
$0.43
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.