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 $0.14 Median $0.14 Typical High $0.14 | Facility | None | $0.14 | $0.14 | $0.14 |
Aetna Setting Professional Modifier None Typical Low $0.14 Median $0.14 Typical High $0.19 | Professional | None | $0.14 | $0.14 | $0.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.03 |
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 |
Molina Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $60.26 | Professional | None | $0.36 | $0.36 | $60.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
Regence BlueShield Setting Professional Modifier AW · With surgical dressing Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | AW · With surgical dressing | $0.38 | $0.38 | $0.38 |
Select Health Setting Facility Modifier None Typical Low $0.50 Median $0.50 Typical High $0.50 | Facility | None | $0.50 | $0.50 | $0.50 |
Select Health Setting Professional Modifier None Typical Low $0.49 Median $0.50 Typical High $0.52 | Professional | None | $0.49 | $0.50 | $0.52 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $0.34 Median $0.37 Typical High $0.54 | Professional | None | $0.34 | $0.37 | $0.54 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.23 Typical High $0.44 | Professional | None | $0.18 | $0.23 | $0.44 |
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 |
|---|---|---|---|---|---|
Regence BlueShield Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | AU · Urologic/ostomy supply | $0.35 | $0.35 | $0.35 |
Regence BlueShield Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | AV · With prosthetic/orthotic | $0.35 | $0.35 | $0.35 |
Where Utah 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.
Utah· 50th of 51
$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.