How much rates vary
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 $0.66 Median $0.66 Typical High $0.81 | Facility | None | $0.66 | $0.66 | $0.81 |
Aetna Setting Professional Modifier None Typical Low $0.66 Median $0.81 Typical High $0.81 | Professional | None | $0.66 | $0.81 | $0.81 |
Ambetter Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
AmeriHealth Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | None | $0.85 | $0.85 | $0.85 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1.20 Median $1.32 Typical High $1.32 | Professional | None | $1.20 | $1.32 | $1.32 |
Cigna Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Facility | None | $0.79 | $0.79 | $0.79 |
Cigna Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | None | $0.68 | $0.68 | $0.68 |
Emblem Health Setting Professional Modifier None Typical Low $1.78 Median $1.95 Typical High $2.51 | Professional | None | $1.78 | $1.95 | $2.51 |
Geisinger Setting Facility Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Facility | None | $1.35 | $1.35 | $1.35 |
Geisinger Setting Professional Modifier None Typical Low $0.66 Median $0.71 Typical High $1.35 | Professional | None | $0.66 | $0.71 | $1.35 |
Martin's Point Setting Facility Modifier None Typical Low $0.66 Median $0.66 Typical High $0.66 | Facility | None | $0.66 | $0.66 | $0.66 |
Martin's Point Setting Professional Modifier None Typical Low $0.66 Median $0.81 Typical High $0.81 | Professional | None | $0.66 | $0.81 | $0.81 |
Oscar Health Setting Professional Modifier None Typical Low $1.20 Median $1.91 Typical High $2.00 | Professional | None | $1.20 | $1.91 | $2.00 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1.00 Median $4.37 Typical High $7.41 | Facility | None | $1.00 | $4.37 | $7.41 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.26 | Professional | None | $1.00 | $1.00 | $1.26 |
United Setting Professional Modifier None Typical Low $0.56 Median $0.68 Typical High $0.95 | Professional | None | $0.56 | $0.68 | $0.95 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $1.00 Median $1.00 Typical High $1.10 | Professional | A1 · Dressing, 1 wound | $1.00 | $1.00 | $1.10 |
Where Pennsylvania sits
The same service costs 2.9 times more in Hawaii 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.
Pennsylvania· 23rd of 51
$0.81
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.