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 $0.32 Median $0.32 Typical High $0.32 | Facility | None | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.27 | Professional | None | $0.23 | $0.23 | $0.27 |
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 Facility Modifier None Typical Low $0.50 Median $0.50 Typical High $0.63 | Facility | None | $0.50 | $0.50 | $0.63 |
Cigna Setting Professional Modifier None Typical Low $0.38 Median $0.47 Typical High $0.54 | Professional | None | $0.38 | $0.47 | $0.54 |
Cigna Setting Professional Modifier AW · With surgical dressing Typical Low $0.58 Median $0.58 Typical High $0.69 | Professional | AW · With surgical dressing | $0.58 | $0.58 | $0.69 |
Medica Setting Facility Modifier None Typical Low $0.38 Median $0.39 Typical High $0.47 | Facility | None | $0.38 | $0.39 | $0.47 |
Medica Setting Professional Modifier None Typical Low $0.22 Median $0.27 Typical High $39.81 | Professional | None | $0.22 | $0.27 | $39.81 |
Midlands Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | None | $0.41 | $0.41 | $0.41 |
Midlands Setting Professional Modifier AW · With surgical dressing Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | AW · With surgical dressing | $0.58 | $0.58 | $0.58 |
Midlands Setting Professional Modifier AW · With surgical dressing Typical Low $0.81 Median $0.81 Typical High $1.00 | Professional | AW · With surgical dressing | $0.81 | $0.81 | $1.00 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.22 Typical High $0.45 | Professional | None | $0.18 | $0.22 | $0.45 |
Wellmark Setting Professional Modifier None Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | None | $0.43 | $0.43 | $0.43 |
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 $0.03 Median $0.03 Typical High $0.04 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.04 |
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 |
Where South Dakota 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.
South Dakota· 10th of 51
$0.38
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.