How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $41Professionalmedian $0 · 10th to 90th $0 to $4
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 $0.36 Median $0.36 Typical High $0.46 | Facility | None | $0.36 | $0.36 | $0.46 |
Aetna Setting Professional Modifier None Typical Low $0.33 Median $0.36 Typical High $0.47 | Professional | None | $0.33 | $0.36 | $0.47 |
Ambetter Setting Professional Modifier None Typical Low $22.91 Median $38.90 Typical High $38.90 | Professional | None | $22.91 | $38.90 | $38.90 |
BCBS Texas Setting Facility Modifier None Typical Low $0.45 Median $0.66 Typical High $1.55 | Facility | None | $0.45 | $0.66 | $1.55 |
BCBS Texas Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Christus Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Lucent Health Setting Professional Modifier None Typical Low $2.75 Median $4.17 Typical High $4.17 | Professional | None | $2.75 | $4.17 | $4.17 |
Moda Health Setting Facility Modifier None Typical Low $0.36 Median $0.51 Typical High $0.58 | Facility | None | $0.36 | $0.51 | $0.58 |
Moda Health Setting Professional Modifier None Typical Low $0.33 Median $0.36 Typical High $0.47 | Professional | None | $0.33 | $0.36 | $0.47 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Providence Setting Facility Modifier None Typical Low $0.36 Median $0.55 Typical High $0.58 | Facility | None | $0.36 | $0.55 | $0.58 |
Providence Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
United Setting Professional Modifier None Typical Low $0.20 Median $0.26 Typical High $0.35 | Professional | None | $0.20 | $0.26 | $0.35 |
Wellpoint Setting Professional Modifier None Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | None | $0.25 | $0.25 | $0.25 |
9 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 $0.17 Median $0.18 Typical High $0.23 | Professional | 52 · Reduced service | $0.17 | $0.18 | $0.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.09 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.07 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.05 |
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | A1 · Dressing, 1 wound | $38.90 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.17 Median $0.18 Typical High $0.22 | Professional | 52 · Reduced service | $0.17 | $0.18 | $0.22 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.09 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.07 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.05 |
Where Texas 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.
Texas· 48th of 51
$0.28
HI $0.59UT $0.23
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.