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 $0.83 Median $0.98 Typical High $0.98 | Facility | None | $0.83 | $0.98 | $0.98 |
Aetna Setting Professional Modifier None Typical Low $0.83 Median $0.83 Typical High $0.98 | Professional | None | $0.83 | $0.83 | $0.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.42 Median $0.42 Typical High $0.49 | Professional | 52 · Reduced service | $0.42 | $0.42 | $0.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.19 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.15 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.10 |
BCBS Mississippi Setting Facility Modifier None Typical Low $0.78 Median $0.78 Typical High $0.83 | Facility | None | $0.78 | $0.78 | $0.83 |
BCBS Mississippi Setting Professional Modifier None Typical Low $0.74 Median $0.74 Typical High $0.74 | Professional | None | $0.74 | $0.74 | $0.74 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $1,995.26 Typical High $1,995.26 | Professional | None | $30.20 | $1,995.26 | $1,995.26 |
United Setting Professional Modifier None Typical Low $0.27 Median $0.44 Typical High $0.55 | Professional | None | $0.27 | $0.44 | $0.55 |
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 Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | A1 · Dressing, 1 wound | $85.11 | $85.11 | $85.11 |
Ambetter Setting Professional Modifier A2 · Dressing, 2 wounds Typical Low $67.61 Median $85.11 Typical High $85.11 | Professional | A2 · Dressing, 2 wounds | $67.61 | $85.11 | $85.11 |
Where Mississippi 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.
Mississippi· 35th 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.