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 $11.75 Median $11.75 Typical High $12.88 | Facility | None | $11.75 | $11.75 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $11.75 Typical High $15.14 | Professional | None | $10.96 | $11.75 | $15.14 |
BCBS Texas Setting Facility Modifier None Typical Low $14.13 Median $20.89 Typical High $50.12 | Facility | None | $14.13 | $20.89 | $50.12 |
BCBS Texas Setting Professional Modifier None Typical Low $8.51 Median $9.55 Typical High $9.55 | Professional | None | $8.51 | $9.55 | $9.55 |
Christus Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $12.30 Typical High $12.30 | Facility | None | $8.91 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.30 | Professional | None | $10.47 | $10.47 | $12.30 |
Lucent Health Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $144.54 | Professional | None | $114.82 | $144.54 | $144.54 |
Moda Health Setting Facility Modifier None Typical Low $5.62 Median $11.75 Typical High $18.20 | Facility | None | $5.62 | $11.75 | $18.20 |
Moda Health Setting Professional Modifier None Typical Low $10.96 Median $11.75 Typical High $16.22 | Professional | None | $10.96 | $11.75 | $16.22 |
Molina Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $81.28 | Professional | None | $10.72 | $10.72 | $81.28 |
Providence Setting Facility Modifier None Typical Low $7.76 Median $12.30 Typical High $18.20 | Facility | None | $7.76 | $12.30 | $18.20 |
Providence Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.30 | Professional | None | $10.47 | $10.47 | $12.30 |
United Setting Professional Modifier None Typical Low $6.61 Median $9.55 Typical High $12.59 | Professional | None | $6.61 | $9.55 | $12.59 |
Wellpoint Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
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 $1.62 Median $1.78 Typical High $2.29 | Professional | 55 · Aftercare only | $1.62 | $1.78 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.17 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.10 | $1.17 | $1.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.78 Typical High $2.29 | Professional | 55 · Aftercare only | $1.66 | $1.78 | $2.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.17 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.10 | $1.17 | $1.51 |
Where Texas sits
The same service costs 3.0 times more in Hawaii 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· 30th of 51
$11.75
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.