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 $0.33 Median $0.33 Typical High $0.33 | Facility | None | $0.33 | $0.33 | $0.33 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.33 Typical High $0.33 | Professional | None | $0.32 | $0.33 | $0.33 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Facility | None | $0.48 | $0.48 | $0.48 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Medica Setting Facility Modifier None Typical Low $0.34 Median $0.35 Typical High $0.78 | Facility | None | $0.34 | $0.35 | $0.78 |
Medica Setting Professional Modifier None Typical Low $0.20 Median $0.35 Typical High $2.69 | Professional | None | $0.20 | $0.35 | $2.69 |
United Setting Professional Modifier None Typical Low $0.16 Median $0.20 Typical High $0.35 | Professional | None | $0.16 | $0.20 | $0.35 |
5 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.16 Median $0.17 Typical High $0.17 | Professional | 52 · Reduced service | $0.16 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.06 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound + A2 · Dressing, 2 wounds Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | A1 · Dressing, 1 wound + A2 · Dressing, 2 wounds | $40.74 | $40.74 | $40.74 |
Where Oklahoma 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.
Oklahoma· 49th 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.