How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $1
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 $0.14 Median $0.23 Typical High $0.36 | Facility | None | $0.14 | $0.23 | $0.36 |
Aetna Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.36 | Professional | None | $0.23 | $0.23 | $0.36 |
Aetna Setting Professional Modifier AW · With surgical dressing Typical Low $0.15 Median $0.15 Typical High $0.27 | Professional | AW · With surgical dressing | $0.15 | $0.15 | $0.27 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.24 Median $0.65 Typical High $1.07 | Professional | None | $0.24 | $0.65 | $1.07 |
Anthem BCBS Setting Professional Modifier AW · With surgical dressing Typical Low $0.44 Median $0.52 Typical High $0.52 | Professional | AW · With surgical dressing | $0.44 | $0.52 | $0.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.15 Median $0.15 Typical High $0.26 | Professional | UE · Used equipment | $0.15 | $0.15 | $0.26 |
Cigna Setting Facility Modifier None Typical Low $0.28 Median $0.45 Typical High $0.45 | Facility | None | $0.28 | $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 |
Emblem Health Setting Facility Modifier None Typical Low $0.50 Median $0.76 Typical High $1.82 | Facility | None | $0.50 | $0.76 | $1.82 |
Emblem Health Setting Professional Modifier None Typical Low $0.46 Median $0.55 Typical High $0.95 | Professional | None | $0.46 | $0.55 | $0.95 |
Emblem Health Setting Professional Modifier AW · With surgical dressing Typical Low $0.56 Median $0.65 Typical High $1.02 | Professional | AW · With surgical dressing | $0.56 | $0.65 | $1.02 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.38 Median $0.38 Typical High $0.38 | Facility | None | $0.38 | $0.38 | $0.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.28 Median $0.34 Typical High $0.38 | Professional | None | $0.28 | $0.34 | $0.38 |
Excellus BCBS Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.28 Median $0.31 Typical High $0.41 | Professional | AU · Urologic/ostomy supply | $0.28 | $0.31 | $0.41 |
Excellus BCBS Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.28 Median $0.31 Typical High $0.41 | Professional | AV · With prosthetic/orthotic | $0.28 | $0.31 | $0.41 |
Excellus BCBS Setting Professional Modifier AW · With surgical dressing Typical Low $0.32 Median $0.34 Typical High $0.45 | Professional | AW · With surgical dressing | $0.32 | $0.34 | $0.45 |
MVP Health Care Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $0.81 | Facility | None | $0.81 | $0.81 | $0.81 |
MVP Health Care Setting Professional Modifier None Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | None | $0.43 | $0.43 | $0.43 |
MVP Health Care Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.31 Median $0.31 Typical High $0.72 | Professional | AU · Urologic/ostomy supply | $0.31 | $0.31 | $0.72 |
MVP Health Care Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.31 Median $0.31 Typical High $0.72 | Professional | AV · With prosthetic/orthotic | $0.31 | $0.31 | $0.72 |
MVP Health Care Setting Professional Modifier AW · With surgical dressing Typical Low $0.34 Median $0.34 Typical High $0.79 | Professional | AW · With surgical dressing | $0.34 | $0.34 | $0.79 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.32 Typical High $0.39 | Professional | None | $0.18 | $0.32 | $0.39 |
United Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | AU · Urologic/ostomy supply | $0.26 | $0.26 | $0.26 |
United Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | AV · With prosthetic/orthotic | $0.26 | $0.26 | $0.26 |
United Setting Professional Modifier AW · With surgical dressing Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | AW · With surgical dressing | $0.28 | $0.28 | $0.28 |
Univera Setting Facility Modifier None Typical Low $0.28 Median $0.38 Typical High $0.38 | Facility | None | $0.28 | $0.38 | $0.38 |
Univera Setting Professional Modifier None Typical Low $0.28 Median $0.34 Typical High $0.38 | Professional | None | $0.28 | $0.34 | $0.38 |
Univera Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.28 Median $0.31 Typical High $0.41 | Professional | AU · Urologic/ostomy supply | $0.28 | $0.31 | $0.41 |
Univera Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.28 Median $0.31 Typical High $0.41 | Professional | AV · With prosthetic/orthotic | $0.28 | $0.31 | $0.41 |
Univera Setting Professional Modifier AW · With surgical dressing Typical Low $0.32 Median $0.34 Typical High $0.45 | Professional | AW · With surgical dressing | $0.32 | $0.34 | $0.45 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.05 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.04 Median $0.06 Typical High $0.44 | Professional | RR · Rental | $0.04 | $0.06 | $0.44 |
Where New York 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.
New York· 17th of 51
$0.32
MT $0.56CO $0.23
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.