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 $0.52 Typical High $0.52 | Facility | None | $0.38 | $0.52 | $0.52 |
Aetna Setting Professional Modifier None Typical Low $0.38 Median $0.52 Typical High $0.52 | Professional | None | $0.38 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.19 Median $0.27 Typical High $0.27 | Professional | 52 · Reduced service | $0.19 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.08 | $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 |
AmeriHealth Setting Facility Modifier None Typical Low $72.44 Median $109.65 Typical High $169.82 | Facility | None | $72.44 | $109.65 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Emblem Health Setting Professional Modifier None Typical Low $1.10 Median $1.48 Typical High $1.48 | Professional | None | $1.10 | $1.48 | $1.48 |
Horizon BCBS Setting Professional Modifier None Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | None | $0.72 | $0.72 | $0.72 |
United Setting Professional Modifier None Typical Low $0.49 Median $0.58 Typical High $0.69 | Professional | None | $0.49 | $0.58 | $0.69 |
1 more rate 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 $83.18 Median $83.18 Typical High $83.18 | Professional | A1 · Dressing, 1 wound | $83.18 | $83.18 | $83.18 |
Where New Jersey 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.
New Jersey· 44th of 51
$0.55
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.