How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $2
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 $0.22 Median $0.22 Typical High $0.22 | Facility | None | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $1.00 | Professional | None | $0.22 | $0.22 | $1.00 |
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 $0.32 Median $0.72 Typical High $1.82 | Professional | None | $0.32 | $0.72 | $1.82 |
Anthem BCBS Setting Professional Modifier AW · With surgical dressing Typical Low $0.40 Median $0.54 Typical High $0.63 | Professional | AW · With surgical dressing | $0.40 | $0.54 | $0.63 |
Cigna Setting Facility Modifier None Typical Low $0.89 Median $1.02 Typical High $1.51 | Facility | None | $0.89 | $1.02 | $1.51 |
Cigna Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.49 | Professional | None | $0.26 | $0.26 | $0.49 |
DeanCare Setting Facility Modifier None Typical Low $0.20 Median $0.52 Typical High $0.71 | Facility | None | $0.20 | $0.52 | $0.71 |
DeanCare Setting Professional Modifier None Typical Low $0.45 Median $0.65 Typical High $0.72 | Professional | None | $0.45 | $0.65 | $0.72 |
DeanCare Setting Professional Modifier AW · With surgical dressing Typical Low $0.45 Median $0.68 Typical High $0.72 | Professional | AW · With surgical dressing | $0.45 | $0.68 | $0.72 |
Medica Setting Facility Modifier None Typical Low $0.20 Median $0.52 Typical High $0.71 | Facility | None | $0.20 | $0.52 | $0.71 |
Medica Setting Professional Modifier None Typical Low $0.26 Median $0.34 Typical High $39.81 | Professional | None | $0.26 | $0.34 | $39.81 |
Network Health Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Network Health Setting Professional Modifier AW · With surgical dressing Typical Low $0.48 Median $0.52 Typical High $1.07 | Professional | AW · With surgical dressing | $0.48 | $0.52 | $1.07 |
Prevea360 Setting Facility Modifier None Typical Low $0.20 Median $0.52 Typical High $0.71 | Facility | None | $0.20 | $0.52 | $0.71 |
Prevea360 Setting Professional Modifier None Typical Low $0.32 Median $0.52 Typical High $0.52 | Professional | None | $0.32 | $0.52 | $0.52 |
Quartz Setting Professional Modifier None Typical Low $0.37 Median $0.65 Typical High $0.91 | Professional | None | $0.37 | $0.65 | $0.91 |
Quartz Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Security Health Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Security Health Setting Professional Modifier AW · With surgical dressing Typical Low $0.54 Median $0.54 Typical High $0.71 | Professional | AW · With surgical dressing | $0.54 | $0.54 | $0.71 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.27 Typical High $0.51 | Professional | None | $0.18 | $0.27 | $0.51 |
16 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 $0.15 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.15 Median $0.40 Typical High $0.40 | Professional | UE · Used equipment | $0.15 | $0.40 | $0.40 |
DeanCare Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.45 Median $0.68 Typical High $0.72 | Professional | AU · Urologic/ostomy supply | $0.45 | $0.68 | $0.72 |
DeanCare Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.45 Median $0.68 Typical High $0.72 | Professional | AV · With prosthetic/orthotic | $0.45 | $0.68 | $0.72 |
DeanCare Setting Professional Modifier KF · Class III device Typical Low $0.45 Median $0.68 Typical High $0.72 | Professional | KF · Class III device | $0.45 | $0.68 | $0.72 |
DeanCare Setting Professional Modifier KL · Delivered by mail Typical Low $0.45 Median $0.68 Typical High $0.72 | Professional | KL · Delivered by mail | $0.45 | $0.68 | $0.72 |
DeanCare Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $0.45 Median $0.68 Typical High $0.72 | Professional | KM · Facial prosthesis, new mold | $0.45 | $0.68 | $0.72 |
DeanCare Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $0.45 Median $0.68 Typical High $0.72 | Professional | KN · Facial prosthesis, prior mold | $0.45 | $0.68 | $0.72 |
DeanCare Setting Professional Modifier RR · Rental Typical Low $0.45 Median $0.68 Typical High $0.72 | Professional | RR · Rental | $0.45 | $0.68 | $0.72 |
DeanCare Setting Professional Modifier UE · Used equipment Typical Low $0.45 Median $0.68 Typical High $0.72 | Professional | UE · Used equipment | $0.45 | $0.68 | $0.72 |
Network Health Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.43 Median $0.47 Typical High $0.98 | Professional | AU · Urologic/ostomy supply | $0.43 | $0.47 | $0.98 |
Network Health Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.43 Median $0.47 Typical High $0.98 | Professional | AV · With prosthetic/orthotic | $0.43 | $0.47 | $0.98 |
Security Health Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | AU · Urologic/ostomy supply | $0.50 | $0.50 | $0.50 |
Security Health Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.50 Median $0.50 Typical High $0.65 | Professional | AU · Urologic/ostomy supply | $0.50 | $0.50 | $0.65 |
Security Health Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.50 Median $0.50 Typical High $0.65 | Professional | AV · With prosthetic/orthotic | $0.50 | $0.50 | $0.65 |
Where Wisconsin 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.
Wisconsin· 8th of 51
$0.38
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.