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 $12.30 Median $12.30 Typical High $13.49 | Facility | None | $12.30 | $12.30 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $12.59 Typical High $16.22 | Professional | None | $11.48 | $12.59 | $16.22 |
Ambetter Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
BCBS Texas Setting Facility Modifier None Typical Low $15.14 Median $22.91 Typical High $54.95 | Facility | None | $15.14 | $22.91 | $54.95 |
BCBS Texas Setting Professional Modifier None Typical Low $9.12 Median $10.23 Typical High $10.23 | Professional | None | $9.12 | $10.23 | $10.23 |
Baylor Scott & White Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $19.50 | Professional | None | $14.45 | $14.45 | $19.50 |
Christus Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $13.49 Typical High $13.49 | Facility | None | $9.55 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | None | $11.48 | $11.48 | $13.49 |
Lucent Health Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $169.82 | Professional | None | $112.20 | $169.82 | $169.82 |
Moda Health Setting Facility Modifier None Typical Low $6.17 Median $12.59 Typical High $19.50 | Facility | None | $6.17 | $12.59 | $19.50 |
Moda Health Setting Professional Modifier None Typical Low $11.48 Median $12.59 Typical High $16.98 | Professional | None | $11.48 | $12.59 | $16.98 |
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 $8.13 Median $13.49 Typical High $19.50 | Facility | None | $8.13 | $13.49 | $19.50 |
Providence Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | None | $11.48 | $11.48 | $13.49 |
United Setting Professional Modifier None Typical Low $7.08 Median $10.23 Typical High $13.49 | Professional | None | $7.08 | $10.23 | $13.49 |
Wellpoint Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
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 $1.74 Median $1.86 Typical High $2.40 | Professional | 55 · Aftercare only | $1.74 | $1.86 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.26 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.17 | $1.26 | $1.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.86 Typical High $2.40 | Professional | 55 · Aftercare only | $1.74 | $1.86 | $2.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.26 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.17 | $1.26 | $1.62 |
Where Texas sits
The same service costs 2.8 times more in Hawaii than in Connecticut. 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· 32nd of 51
$12.30
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.