How much rates vary
Facilitymedian $38 · 10th to 90th $2 to $107Professionalmedian $2 · 10th to 90th $1 to $2
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 $1.20 Median $1.20 Typical High $1,584.89 | Facility | None | $1.20 | $1.20 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $1.20 Median $1.51 Typical High $1.51 | Professional | None | $1.20 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.60 Median $0.76 Typical High $0.76 | Professional | 52 · Reduced service | $0.60 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.30 Typical High $0.30 | Professional | 53 · Discontinued | $0.24 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.18 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.12 | $0.15 | $0.15 |
Ambetter Setting Professional Modifier None Typical Low $1.45 Median $4.07 Typical High $4.07 | Professional | None | $1.45 | $4.07 | $4.07 |
AmeriHealth Setting Facility Modifier None Typical Low $26.30 Median $61.66 Typical High $93.33 | Facility | None | $26.30 | $61.66 | $93.33 |
AmeriHealth Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $2.19 Median $2.45 Typical High $2.45 | Professional | None | $2.19 | $2.45 | $2.45 |
Cigna Setting Facility Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Facility | None | $1.48 | $1.48 | $1.48 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Emblem Health Setting Professional Modifier None Typical Low $3.31 Median $3.63 Typical High $4.57 | Professional | None | $3.31 | $3.63 | $4.57 |
Geisinger Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
Geisinger Setting Professional Modifier None Typical Low $1.23 Median $1.29 Typical High $2.51 | Professional | None | $1.23 | $1.29 | $2.51 |
Highmark BCBS Setting Facility Modifier None Typical Low $8.91 Median $10.47 Typical High $12.30 | Facility | None | $8.91 | $10.47 | $12.30 |
Independence Blue Cross Setting Facility Modifier None Typical Low $26.92 Median $51.29 Typical High $93.33 | Facility | None | $26.92 | $51.29 | $93.33 |
Martin's Point Setting Facility Modifier None Typical Low $1.20 Median $1.20 Typical High $1,584.89 | Facility | None | $1.20 | $1.20 | $1,584.89 |
Martin's Point Setting Professional Modifier None Typical Low $1.20 Median $1.51 Typical High $1.51 | Professional | None | $1.20 | $1.51 | $1.51 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.60 Median $0.76 Typical High $0.76 | Professional | 52 · Reduced service | $0.60 | $0.76 | $0.76 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.30 Typical High $0.30 | Professional | 53 · Discontinued | $0.24 | $0.30 | $0.30 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.18 | $0.23 | $0.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.12 | $0.15 | $0.15 |
Oscar Health Setting Professional Modifier None Typical Low $2.51 Median $3.47 Typical High $3.72 | Professional | None | $2.51 | $3.47 | $3.72 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1.62 Median $7.94 Typical High $13.49 | Facility | None | $1.62 | $7.94 | $13.49 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $2.34 | Professional | None | $1.62 | $1.62 | $2.34 |
United Setting Professional Modifier None Typical Low $1.05 Median $1.23 Typical High $1.74 | Professional | None | $1.05 | $1.23 | $1.74 |
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 $1.86 Median $1.86 Typical High $1.86 | Professional | A1 · Dressing, 1 wound | $1.86 | $1.86 | $1.86 |
Highmark BCBS Setting Professional Modifier A1 · Dressing, 1 wound + A2 · Dressing, 2 wounds + A3 · Dressing, 3 wounds + A4 · Dressing, 4 wounds + AW · With surgical dressing Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | A1 · Dressing, 1 wound + A2 · Dressing, 2 wounds + A3 · Dressing, 3 wounds + A4 · Dressing, 4 wounds + AW · With surgical dressing | $1.82 | $1.82 | $1.82 |
Where Pennsylvania 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.
Pennsylvania· 23rd of 51
$1.51
HI $2.69UT $1.05
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.