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 $1.00 Median $1.00 Typical High $1.26 | Facility | None | $1.00 | $1.00 | $1.26 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.26 Typical High $1.32 | Professional | None | $1.00 | $1.26 | $1.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.51 Median $0.63 Typical High $0.66 | Professional | 52 · Reduced service | $0.51 | $0.63 | $0.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.25 Typical High $0.26 | Professional | 53 · Discontinued | $0.20 | $0.25 | $0.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.19 Typical High $0.20 | Professional | 55 · Aftercare only | $0.15 | $0.19 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.10 | $0.13 | $0.13 |
BCBS Louisiana Setting Facility Modifier None Typical Low $1.55 Median $2.69 Typical High $3.80 | Facility | None | $1.55 | $2.69 | $3.80 |
BCBS Louisiana Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Christus Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
United Setting Professional Modifier None Typical Low $0.50 Median $0.83 Typical High $1.07 | Professional | None | $0.50 | $0.83 | $1.07 |
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 $1.58 Median $1.58 Typical High $1.58 | Professional | A1 · Dressing, 1 wound | $1.58 | $1.58 | $1.58 |
Where Louisiana sits
The same service costs 2.5 times more in Idaho than in Colorado. 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.
Louisiana· 34th of 51
$0.93
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.