How much rates vary
Facilitymedian $1 · 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 Professional Modifier None Typical Low $0.21 Median $0.33 Typical High $0.33 | Professional | None | $0.21 | $0.33 | $0.33 |
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 |
Cigna Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.65 Median $0.74 Typical High $151.36 | Professional | None | $0.65 | $0.74 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $0.38 Median $0.47 Typical High $0.51 | Facility | None | $0.38 | $0.47 | $0.51 |
Moda Health Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $0.45 | Professional | None | $0.33 | $0.33 | $0.45 |
Moda Health Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.38 Median $0.48 Typical High $0.51 | Professional | AU · Urologic/ostomy supply | $0.38 | $0.48 | $0.51 |
Moda Health Setting Professional Modifier AW · With surgical dressing Typical Low $0.15 Median $0.48 Typical High $0.52 | Professional | AW · With surgical dressing | $0.15 | $0.48 | $0.52 |
Pacific Source Setting Facility Modifier None Typical Low $0.40 Median $0.52 Typical High $0.66 | Facility | None | $0.40 | $0.52 | $0.66 |
Pacific Source Setting Professional Modifier None Typical Low $0.43 Median $0.47 Typical High $0.49 | Professional | None | $0.43 | $0.47 | $0.49 |
Providence Setting Facility Modifier None Typical Low $0.31 Median $0.44 Typical High $0.83 | Facility | None | $0.31 | $0.44 | $0.83 |
Providence Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $79.43 | Professional | None | $0.26 | $0.26 | $79.43 |
Providence Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.41 Median $0.47 Typical High $0.50 | Professional | AU · Urologic/ostomy supply | $0.41 | $0.47 | $0.50 |
Providence Setting Professional Modifier AW · With surgical dressing Typical Low $0.47 Median $0.51 Typical High $0.56 | Professional | AW · With surgical dressing | $0.47 | $0.51 | $0.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.69 Median $0.78 Typical High $0.91 | Professional | None | $0.69 | $0.78 | $0.91 |
Regence BlueShield Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.52 Median $0.55 Typical High $0.55 | Professional | AU · Urologic/ostomy supply | $0.52 | $0.55 | $0.55 |
Regence BlueShield Setting Professional Modifier AW · With surgical dressing Typical Low $0.56 Median $0.59 Typical High $0.59 | Professional | AW · With surgical dressing | $0.56 | $0.59 | $0.59 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.23 Typical High $0.44 | Professional | None | $0.18 | $0.23 | $0.44 |
6 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 |
Moda Health 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 |
Moda Health 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 |
Providence Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.43 Median $0.47 Typical High $0.50 | Professional | AV · With prosthetic/orthotic | $0.43 | $0.47 | $0.50 |
Regence BlueShield Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.52 Median $0.55 Typical High $0.55 | Professional | AV · With prosthetic/orthotic | $0.52 | $0.55 | $0.55 |
Where Oregon 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.
Oregon· 15th of 51
$0.33
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.