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 $1.58 Median $1.58 Typical High $1.78 | Facility | None | $1.58 | $1.58 | $1.78 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.58 Typical High $1.78 | Professional | None | $1.38 | $1.58 | $1.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.24 Typical High $0.27 | Professional | 55 · Aftercare only | $0.21 | $0.24 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.16 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.14 | $0.16 | $0.18 |
Ambetter Setting Professional Modifier None Typical Low $1.55 Median $1.58 Typical High $1.58 | Professional | None | $1.55 | $1.58 | $1.58 |
BCBS Texas Setting Facility Modifier None Typical Low $1.45 Median $1.45 Typical High $1.55 | Facility | None | $1.45 | $1.45 | $1.55 |
BCBS Texas Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Lucent Health Setting Professional Modifier None Typical Low $12.88 Median $16.60 Typical High $16.60 | Professional | None | $12.88 | $16.60 | $16.60 |
Moda Health Setting Facility Modifier None Typical Low $1.58 Median $2.09 Typical High $3.02 | Facility | None | $1.58 | $2.09 | $3.02 |
Moda Health Setting Professional Modifier None Typical Low $1.38 Median $1.58 Typical High $1.78 | Professional | None | $1.38 | $1.58 | $1.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.24 Typical High $0.27 | Professional | 55 · Aftercare only | $0.21 | $0.24 | $0.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.16 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.14 | $0.16 | $0.18 |
Molina Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $30.20 | Professional | None | $1.86 | $1.86 | $30.20 |
Providence Setting Facility Modifier None Typical Low $1.58 Median $2.29 Typical High $2.95 | Facility | None | $1.58 | $2.29 | $2.95 |
Providence Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.29 Typical High $2.29 | Professional | None | $1.10 | $1.29 | $2.29 |
Wellpoint Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
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 Q6 · Substitute physician, paid per time Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | Q6 · Substitute physician, paid per time | $1.51 | $1.51 | $1.51 |
Where Texas sits
The same service costs 6.0 times more in Minnesota than in Rhode Island. 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· 5th of 51
$3.31
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.