How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.62 Median $0.87 Typical High $0.87 | Facility | None | $0.62 | $0.87 | $0.87 |
Aetna Setting Professional Modifier None Typical Low $0.62 Median $0.87 Typical High $0.87 | Professional | None | $0.62 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.31 Median $0.44 Typical High $0.44 | Professional | 52 · Reduced service | $0.31 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.17 Typical High $0.17 | Professional | 53 · Discontinued | $0.12 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.09 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.06 | $0.09 | $0.09 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Emblem Health Setting Professional Modifier None Typical Low $1.74 Median $2.34 Typical High $2.34 | Professional | None | $1.74 | $2.34 | $2.34 |
Horizon BCBS Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | None | $1.17 | $1.17 | $1.17 |
United Setting Professional Modifier None Typical Low $0.79 Median $0.95 Typical High $1.12 | Professional | None | $0.79 | $0.95 | $1.12 |
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 $1.35 Median $1.35 Typical High $1.35 | Professional | A1 · Dressing, 1 wound | $1.35 | $1.35 | $1.35 |
Where New Jersey 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.
New Jersey· 41st of 51
$0.89
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.