How much rates vary
Facilitymedian $3 · 10th to 90th $0 to $5,012Professionalmedian $1 · 10th to 90th $0 to $1
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 $0.43 Median $0.43 Typical High $0.54 | Facility | None | $0.43 | $0.43 | $0.54 |
Aetna Setting Professional Modifier None Typical Low $0.43 Median $0.54 Typical High $0.54 | Professional | None | $0.43 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.22 Median $0.27 Typical High $0.27 | Professional | 52 · Reduced service | $0.22 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.09 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.06 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.05 | $0.05 |
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 $0.79 Median $0.87 Typical High $0.87 | Professional | None | $0.79 | $0.87 | $0.87 |
Cigna Setting Facility Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Facility | None | $0.52 | $0.52 | $0.52 |
Cigna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | None | $0.45 | $0.45 | $0.45 |
Emblem Health Setting Professional Modifier None Typical Low $1.17 Median $1.29 Typical High $1.66 | Professional | None | $1.17 | $1.29 | $1.66 |
Geisinger Setting Facility Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Facility | None | $0.89 | $0.89 | $0.89 |
Geisinger Setting Professional Modifier None Typical Low $0.54 Median $0.59 Typical High $0.89 | Professional | None | $0.54 | $0.59 | $0.89 |
Martin's Point Setting Facility Modifier None Typical Low $0.43 Median $0.43 Typical High $0.43 | Facility | None | $0.43 | $0.43 | $0.43 |
Martin's Point Setting Professional Modifier None Typical Low $0.43 Median $0.54 Typical High $0.54 | Professional | None | $0.43 | $0.54 | $0.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.22 Median $0.27 Typical High $0.27 | Professional | 52 · Reduced service | $0.22 | $0.27 | $0.27 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.09 | $0.11 | $0.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.06 | $0.08 | $0.08 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.05 | $0.05 |
Oscar Health Setting Professional Modifier None Typical Low $0.89 Median $1.20 Typical High $1.29 | Professional | None | $0.89 | $1.20 | $1.29 |
UPMC Health Plan Setting Facility Modifier None Typical Low $0.56 Median $2.75 Typical High $4.79 | Facility | None | $0.56 | $2.75 | $4.79 |
UPMC Health Plan Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.83 | Professional | None | $0.56 | $0.56 | $0.83 |
United Setting Professional Modifier None Typical Low $0.37 Median $0.44 Typical High $0.62 | Professional | None | $0.37 | $0.44 | $0.62 |
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 $67.61 Median $67.61 Typical High $67.61 | Professional | A1 · Dressing, 1 wound | $67.61 | $67.61 | $67.61 |
Highmark BCBS Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | A1 · Dressing, 1 wound | $0.66 | $0.66 | $0.66 |
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
$0.54
HI $0.98UT $0.37
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.