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 $5.62 Median $5.62 Typical High $12.88 | Facility | None | $5.62 | $5.62 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $7.76 | Professional | None | $5.62 | $5.62 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $4.27 Typical High $9.12 | Professional | None | $3.09 | $4.27 | $9.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.69 Median $3.24 Typical High $4.90 | Professional | UE · Used equipment | $2.69 | $3.24 | $4.90 |
CareSource Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
CareSource Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $12.02 | Professional | None | $11.48 | $11.48 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Molina Setting Professional Modifier None Typical Low $3.89 Median $5.37 Typical High $7.94 | Professional | None | $3.89 | $5.37 | $7.94 |
SummaCare Setting Professional Modifier None Typical Low $7.76 Median $9.12 Typical High $12.30 | Professional | None | $7.76 | $9.12 | $12.30 |
United Setting Professional Modifier None Typical Low $2.95 Median $4.37 Typical High $5.37 | Professional | None | $2.95 | $4.37 | $5.37 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound + A4 · Dressing, 4 wounds Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | A1 · Dressing, 1 wound + A4 · Dressing, 4 wounds | $6.76 | $6.76 | $6.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.39 Median $0.39 Typical High $0.52 | Professional | RR · Rental | $0.39 | $0.39 | $0.52 |
Where Ohio sits
The same service costs 3.2 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.
Ohio· 46th of 51
$4.47
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.