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 $28.84 Median $28.84 Typical High $31.62 | Facility | None | $28.84 | $28.84 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $28.84 Typical High $33.88 | Professional | None | $26.92 | $28.84 | $33.88 |
BCBS Texas Setting Facility Modifier None Typical Low $35.48 Median $46.77 Typical High $120.23 | Facility | None | $35.48 | $46.77 | $120.23 |
BCBS Texas Setting Professional Modifier None Typical Low $20.89 Median $23.44 Typical High $23.44 | Professional | None | $20.89 | $23.44 | $23.44 |
Christus Setting Facility Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $26.92 Typical High $33.11 | Facility | None | $22.39 | $26.92 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | None | $22.91 | $22.91 | $26.92 |
Lucent Health Setting Professional Modifier None Typical Low $223.87 Median $398.11 Typical High $398.11 | Professional | None | $223.87 | $398.11 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $12.02 Median $26.92 Typical High $45.71 | Facility | None | $12.02 | $26.92 | $45.71 |
Moda Health Setting Professional Modifier None Typical Low $26.92 Median $28.84 Typical High $38.90 | Professional | None | $26.92 | $28.84 | $38.90 |
Molina Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $81.28 | Professional | None | $17.78 | $17.78 | $81.28 |
Providence Setting Facility Modifier None Typical Low $19.05 Median $26.92 Typical High $45.71 | Facility | None | $19.05 | $26.92 | $45.71 |
Providence Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | None | $22.91 | $22.91 | $26.92 |
United Setting Professional Modifier None Typical Low $13.49 Median $20.42 Typical High $26.92 | Professional | None | $13.49 | $20.42 | $26.92 |
Wellpoint Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
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 $3.98 Median $4.37 Typical High $5.37 | Professional | 55 · Aftercare only | $3.98 | $4.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.88 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.69 | $2.88 | $3.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.37 Typical High $5.37 | Professional | 55 · Aftercare only | $3.98 | $4.37 | $5.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.88 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.69 | $2.88 | $3.55 |
Where Texas sits
The same service costs 2.5 times more in Idaho than in Kentucky. 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
$26.92
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.