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 $0.38 Median $0.81 Typical High $6.76 | Facility | None | $0.38 | $0.81 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $0.38 Median $0.54 Typical High $0.87 | Professional | None | $0.38 | $0.54 | $0.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.38 Median $0.52 Typical High $0.78 | Professional | None | $0.38 | $0.52 | $0.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.28 Median $0.38 Typical High $0.68 | Professional | UE · Used equipment | $0.28 | $0.38 | $0.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.89 | Professional | None | $0.54 | $0.54 | $0.89 |
Cigna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | None | $0.45 | $0.45 | $0.45 |
Medica Setting Facility Modifier None Typical Low $0.47 Median $1.07 Typical High $79.43 | Facility | None | $0.47 | $1.07 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.31 Median $0.44 Typical High $4.37 | Professional | None | $0.31 | $0.44 | $4.37 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.43 Typical High $0.72 | Professional | None | $0.28 | $0.43 | $0.72 |
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 $0.19 Median $0.27 Typical High $0.44 | Professional | 52 · Reduced service | $0.19 | $0.27 | $0.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.11 Typical High $0.18 | Professional | 53 · Discontinued | $0.08 | $0.11 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.08 Typical High $0.13 | Professional | 55 · Aftercare only | $0.06 | $0.08 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.05 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.04 | $0.05 | $0.09 |
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | A1 · Dressing, 1 wound | $63.10 | $63.10 | $63.10 |
Where Missouri 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.
Missouri· 24th of 51
$0.52
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.