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 $19.05 Median $22.91 Typical High $25.70 | Facility | None | $19.05 | $22.91 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $23.44 Typical High $28.84 | Professional | None | $21.38 | $23.44 | $28.84 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
BCBS Texas Setting Facility Modifier None Typical Low $28.18 Median $40.74 Typical High $95.50 | Facility | None | $28.18 | $40.74 | $95.50 |
BCBS Texas Setting Professional Modifier None Typical Low $16.98 Median $19.05 Typical High $19.05 | Professional | None | $16.98 | $19.05 | $19.05 |
Christus Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $21.38 Typical High $26.30 | Facility | None | $12.59 | $21.38 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | None | $18.20 | $18.20 | $21.38 |
Lucent Health Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $263.03 | Professional | None | $177.83 | $263.03 | $263.03 |
Moda Health Setting Facility Modifier None Typical Low $9.77 Median $22.91 Typical High $36.31 | Facility | None | $9.77 | $22.91 | $36.31 |
Moda Health Setting Professional Modifier None Typical Low $21.38 Median $23.44 Typical High $30.90 | Professional | None | $21.38 | $23.44 | $30.90 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $81.28 | Professional | None | $20.42 | $20.42 | $81.28 |
Providence Setting Facility Modifier None Typical Low $12.59 Median $21.38 Typical High $36.31 | Facility | None | $12.59 | $21.38 | $36.31 |
Providence Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | None | $18.20 | $18.20 | $21.38 |
United Setting Professional Modifier None Typical Low $11.22 Median $16.22 Typical High $21.38 | Professional | None | $11.22 | $16.22 | $21.38 |
Wellpoint Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
5 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 $3.24 Median $3.47 Typical High $4.27 | Professional | 55 · Aftercare only | $3.24 | $3.47 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.29 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.14 | $2.29 | $2.88 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | KX · Policy requirements met | $21.38 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.47 Typical High $4.27 | Professional | 55 · Aftercare only | $3.24 | $3.47 | $4.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.34 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.14 | $2.34 | $2.88 |
Where Texas sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 26th of 51
$21.38
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.