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 $0.55 Median $0.55 Typical High $0.68 | Facility | None | $0.55 | $0.55 | $0.68 |
Aetna Setting Professional Modifier None Typical Low $0.55 Median $0.68 Typical High $0.72 | Professional | None | $0.55 | $0.68 | $0.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.28 Median $0.34 Typical High $0.36 | Professional | 52 · Reduced service | $0.28 | $0.34 | $0.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.11 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.10 Typical High $0.11 | Professional | 55 · Aftercare only | $0.08 | $0.10 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.07 | $0.07 |
BCBS Louisiana Setting Facility Modifier None Typical Low $0.83 Median $1.45 Typical High $2.04 | Facility | None | $0.83 | $1.45 | $2.04 |
BCBS Louisiana Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | None | $0.60 | $0.60 | $0.60 |
Christus Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
United Setting Professional Modifier None Typical Low $0.27 Median $0.45 Typical High $0.58 | Professional | None | $0.27 | $0.45 | $0.58 |
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 $85.11 | Professional | A1 · Dressing, 1 wound | $67.61 | $67.61 | $85.11 |
Where Louisiana 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.
Louisiana· 33rd of 51
$0.51
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.