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 $23.44 Median $23.44 Typical High $25.70 | Facility | None | $23.44 | $23.44 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $23.44 Typical High $29.51 | Professional | None | $21.88 | $23.44 | $29.51 |
BCBS Texas Setting Facility Modifier None Typical Low $28.84 Median $39.81 Typical High $95.50 | Facility | None | $28.84 | $39.81 | $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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $21.88 Typical High $21.88 | Facility | None | $18.20 | $21.88 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.88 | Professional | None | $18.62 | $18.62 | $21.88 |
Lucent Health Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $281.84 | Professional | None | $199.53 | $281.84 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $10.00 Median $23.44 Typical High $36.31 | Facility | None | $10.00 | $23.44 | $36.31 |
Moda Health Setting Professional Modifier None Typical Low $21.88 Median $23.44 Typical High $30.90 | Professional | None | $21.88 | $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 $15.49 Median $21.88 Typical High $36.31 | Facility | None | $15.49 | $21.88 | $36.31 |
Providence Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.88 | Professional | None | $18.62 | $18.62 | $21.88 |
United Setting Professional Modifier None Typical Low $11.75 Median $16.98 Typical High $22.39 | Professional | None | $11.75 | $16.98 | $22.39 |
Wellpoint Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
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 $3.55 Typical High $4.47 | Professional | 55 · Aftercare only | $3.24 | $3.55 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.34 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.19 | $2.34 | $2.95 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | KX · Policy requirements met | $22.39 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.55 Typical High $4.37 | Professional | 55 · Aftercare only | $3.24 | $3.55 | $4.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.34 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.19 | $2.34 | $2.95 |
Where Texas sits
The same service costs 2.9 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· 28th of 51
$21.88
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.