How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $16Professionalmedian $0 · 10th to 90th $0 to $40
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 $0.26 Median $0.26 Typical High $0.30 | Facility | None | $0.26 | $0.26 | $0.30 |
Aetna Setting Professional Modifier None Typical Low $0.23 Median $0.27 Typical High $0.30 | Professional | None | $0.23 | $0.27 | $0.30 |
Aetna Setting Professional Modifier AW · With surgical dressing Typical Low $0.15 Median $0.15 Typical High $0.32 | Professional | AW · With surgical dressing | $0.15 | $0.15 | $0.32 |
Ambetter Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $33.11 | Professional | None | $21.88 | $21.88 | $33.11 |
Ambetter Setting Professional Modifier AW · With surgical dressing Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | AW · With surgical dressing | $38.02 | $38.02 | $38.02 |
BCBS Texas Setting Facility Modifier None Typical Low $0.44 Median $0.65 Typical High $1.51 | Facility | None | $0.44 | $0.65 | $1.51 |
BCBS Texas Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Christus Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Lucent Health Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Moda Health Setting Facility Modifier None Typical Low $0.26 Median $0.42 Typical High $0.54 | Facility | None | $0.26 | $0.42 | $0.54 |
Moda Health Setting Professional Modifier None Typical Low $0.23 Median $0.27 Typical High $0.30 | Professional | None | $0.23 | $0.27 | $0.30 |
Moda Health Setting Professional Modifier AW · With surgical dressing Typical Low $0.15 Median $0.15 Typical High $0.34 | Professional | AW · With surgical dressing | $0.15 | $0.15 | $0.34 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Providence Setting Facility Modifier None Typical Low $0.27 Median $0.46 Typical High $0.54 | Facility | None | $0.27 | $0.46 | $0.54 |
Providence Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
United Setting Professional Modifier None Typical Low $0.19 Median $0.26 Typical High $0.34 | Professional | None | $0.19 | $0.26 | $0.34 |
Wellpoint Setting Professional Modifier None Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | None | $0.21 | $0.21 | $0.21 |
5 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 $0.04 Typical High $0.05 | Professional | 55 · Aftercare only | $0.03 | $0.04 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.03 | $0.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.04 Typical High $0.05 | Professional | 55 · Aftercare only | $0.03 | $0.04 | $0.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.03 | $0.03 |
Moda Health Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.43 Median $0.48 Typical High $0.51 | Professional | AU · Urologic/ostomy supply | $0.43 | $0.48 | $0.51 |
Where Texas 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.
Texas· 32nd of 51
$0.26
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.