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 $0.20 Median $0.28 Typical High $0.28 | Facility | None | $0.20 | $0.28 | $0.28 |
Aetna Setting Professional Modifier None Typical Low $0.20 Median $0.28 Typical High $0.28 | Professional | None | $0.20 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.10 Median $0.14 Typical High $0.14 | Professional | 52 · Reduced service | $0.10 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.06 Typical High $0.06 | Professional | 53 · Discontinued | $0.04 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 55 · Aftercare only | $0.03 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.03 | $0.03 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Emblem Health Setting Professional Modifier None Typical Low $0.54 Median $0.72 Typical High $0.72 | Professional | None | $0.54 | $0.72 | $0.72 |
Horizon BCBS Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | None | $0.37 | $0.37 | $0.37 |
United Setting Professional Modifier None Typical Low $0.26 Median $0.31 Typical High $0.36 | Professional | None | $0.26 | $0.31 | $0.36 |
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 $40.74 Median $40.74 Typical High $40.74 | Professional | A1 · Dressing, 1 wound | $40.74 | $40.74 | $40.74 |
Where New Jersey sits
The same service costs 2.6 times more in Hawaii than in Utah. 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.
New Jersey· 44th of 51
$0.28
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.