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 $2.14 Median $2.51 Typical High $2.51 | Facility | None | $2.14 | $2.51 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.51 | Professional | None | $2.14 | $2.14 | $2.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.07 Median $1.07 Typical High $1.26 | Professional | 52 · Reduced service | $1.07 | $1.07 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.43 Typical High $0.50 | Professional | 53 · Discontinued | $0.43 | $0.43 | $0.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.32 Typical High $0.38 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.25 |
Ambetter Setting Professional Modifier None Typical Low $1.48 Median $1.62 Typical High $1.74 | Professional | None | $1.48 | $1.62 | $1.74 |
BCBS Mississippi Setting Facility Modifier None Typical Low $2.00 Median $2.00 Typical High $2.19 | Facility | None | $2.00 | $2.00 | $2.19 |
BCBS Mississippi Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
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 $0.69 Median $1.15 Typical High $1.41 | Professional | None | $0.69 | $1.15 | $1.41 |
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 $2.19 Median $2.19 Typical High $2.19 | Professional | A1 · Dressing, 1 wound | $2.19 | $2.19 | $2.19 |
Ambetter Setting Professional Modifier A2 · Dressing, 2 wounds Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | A2 · Dressing, 2 wounds | $2.19 | $2.19 | $2.19 |
Where Mississippi 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.
Mississippi· 25th of 51
$1.48
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.