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 $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $169.82 | Professional | None | $138.04 | $154.88 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $208.93 | Professional | None | $58.88 | $58.88 | $208.93 |
BCBS Texas Setting Facility Modifier None Typical Low $123.03 Median $302.00 Typical High $562.34 | Facility | None | $123.03 | $302.00 | $562.34 |
BCBS Texas Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Christus Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $218.78 Typical High $467.74 | Facility | None | $144.54 | $218.78 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Moda Health Setting Facility Modifier None Typical Low $63.10 Median $154.88 Typical High $407.38 | Facility | None | $63.10 | $154.88 | $407.38 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $173.78 | Professional | None | $131.83 | $154.88 | $173.78 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $109.65 Median $169.82 Typical High $1,258.93 | Facility | None | $109.65 | $169.82 | $1,258.93 |
Providence Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $154.88 | Professional | None | $123.03 | $147.91 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
4 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 55 · Aftercare only Typical Low $20.89 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $20.89 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $13.80 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $15.49 |
Where Texas sits
The same service costs 4.1 times more in Colorado than in Alabama. 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.
Texas· 6th of 51
$148
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.