How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $1,738Professionalmedian $0 · 10th to 90th $0 to $0
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 $0.27 Median $0.27 Typical High $0.28 | Facility | None | $0.27 | $0.27 | $0.28 |
Aetna Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.28 | Professional | None | $0.27 | $0.27 | $0.28 |
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 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | None | $0.20 | $0.20 | $0.20 |
CareFirst Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Cigna Setting Facility Modifier None Typical Low $0.30 Median $0.30 Typical High $0.30 | Facility | None | $0.30 | $0.30 | $0.30 |
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 $0.33 Median $0.39 Typical High $0.62 | Professional | None | $0.33 | $0.39 | $0.62 |
Kaiser Permanente Setting Professional Modifier AW · With surgical dressing Typical Low $0.46 Median $0.59 Typical High $0.85 | Professional | AW · With surgical dressing | $0.46 | $0.59 | $0.85 |
Medcost Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $0.54 | Professional | None | $0.50 | $0.50 | $0.54 |
Medcost Setting Professional Modifier AW · With surgical dressing Typical Low $0.40 Median $0.40 Typical High $0.56 | Professional | AW · With surgical dressing | $0.40 | $0.40 | $0.56 |
Medcost Setting Facility Modifier None Typical Low $0.27 Median $0.63 Typical High $0.81 | Facility | None | $0.27 | $0.63 | $0.81 |
Medcost Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $0.37 | Professional | None | $0.30 | $0.30 | $0.37 |
Sentara Setting Facility Modifier None Typical Low $0.36 Median $0.68 Typical High $2,454.71 | Facility | None | $0.36 | $0.68 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $0.32 Median $0.42 Typical High $0.91 | Professional | None | $0.32 | $0.42 | $0.91 |
Sentara Setting Professional Modifier AW · With surgical dressing Typical Low $0.32 Median $0.44 Typical High $0.72 | Professional | AW · With surgical dressing | $0.32 | $0.44 | $0.72 |
United Setting Professional Modifier None Typical Low $0.25 Median $0.27 Typical High $0.42 | Professional | None | $0.25 | $0.27 | $0.42 |
8 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 $0.04 Median $0.04 Typical High $0.04 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.04 |
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 |
Kaiser Permanente Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.43 Median $0.55 Typical High $0.79 | Professional | AU · Urologic/ostomy supply | $0.43 | $0.55 | $0.79 |
Kaiser Permanente Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.43 Median $0.55 Typical High $0.79 | Professional | AV · With prosthetic/orthotic | $0.43 | $0.55 | $0.79 |
Medcost Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.36 Median $0.36 Typical High $0.50 | Professional | AU · Urologic/ostomy supply | $0.36 | $0.36 | $0.50 |
Medcost Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.36 Median $0.36 Typical High $0.50 | Professional | AV · With prosthetic/orthotic | $0.36 | $0.36 | $0.50 |
Sentara Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.28 Median $0.40 Typical High $0.68 | Professional | AU · Urologic/ostomy supply | $0.28 | $0.40 | $0.68 |
Sentara Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.28 Median $0.40 Typical High $0.68 | Professional | AV · With prosthetic/orthotic | $0.28 | $0.40 | $0.68 |
Where Virginia 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.
Virginia· 29th of 51
$0.27
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.