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 $0.42 Median $0.69 Typical High $0.72 | Facility | None | $0.42 | $0.69 | $0.72 |
Aetna Setting Professional Modifier None Typical Low $0.42 Median $0.69 Typical High $0.72 | Professional | None | $0.42 | $0.69 | $0.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.21 Median $0.35 Typical High $0.36 | Professional | 52 · Reduced service | $0.21 | $0.35 | $0.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.08 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.10 Typical High $0.11 | Professional | 55 · Aftercare only | $0.06 | $0.10 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.04 | $0.07 | $0.07 |
AvMed Setting Facility Modifier None Typical Low $0.78 Median $0.78 Typical High $0.78 | Facility | None | $0.78 | $0.78 | $0.78 |
AvMed Setting Professional Modifier None Typical Low $0.71 Median $0.83 Typical High $0.98 | Professional | None | $0.71 | $0.83 | $0.98 |
Cigna Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Facility | None | $1.32 | $1.32 | $1.32 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Florida Blue Setting Facility Modifier None Typical Low $0.91 Median $0.91 Typical High $0.91 | Facility | None | $0.91 | $0.91 | $0.91 |
Florida Blue Setting Professional Modifier None Typical Low $0.28 Median $0.58 Typical High $0.72 | Professional | None | $0.28 | $0.58 | $0.72 |
Molina Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
United Setting Professional Modifier None Typical Low $0.41 Median $0.56 Typical High $60.26 | Professional | None | $0.41 | $0.56 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $0.43 Median $0.43 Typical High $0.98 | Professional | None | $0.43 | $0.43 | $0.98 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | A1 · Dressing, 1 wound | $67.61 | $67.61 | $67.61 |
Where Florida sits
The same service costs 2.6 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.
Florida· 39th of 51
$0.49
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.