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 $5.75 Median $5.75 Typical High $6.31 | Facility | None | $5.75 | $5.75 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.89 Typical High $6.92 | Professional | None | $5.37 | $5.89 | $6.92 |
Ambetter Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
BCBS Texas Setting Facility Modifier None Typical Low $7.08 Median $10.47 Typical High $25.12 | Facility | None | $7.08 | $10.47 | $25.12 |
BCBS Texas Setting Professional Modifier None Typical Low $4.27 Median $4.79 Typical High $4.79 | Professional | None | $4.27 | $4.79 | $4.79 |
Christus Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $5.37 | Professional | None | $4.57 | $4.57 | $5.37 |
Health Smart Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Lucent Health Setting Professional Modifier None Typical Low $63.10 Median $562.34 Typical High $562.34 | Professional | None | $63.10 | $562.34 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $2.45 Median $5.75 Typical High $9.12 | Facility | None | $2.45 | $5.75 | $9.12 |
Moda Health Setting Professional Modifier None Typical Low $5.13 Median $5.89 Typical High $7.76 | Professional | None | $5.13 | $5.89 | $7.76 |
Molina Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $81.28 | Professional | None | $5.13 | $5.13 | $81.28 |
Providence Setting Facility Modifier None Typical Low $3.80 Median $5.37 Typical High $9.12 | Facility | None | $3.80 | $5.37 | $9.12 |
Providence Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $5.37 | Professional | None | $4.57 | $4.57 | $5.37 |
United Setting Professional Modifier None Typical Low $2.75 Median $4.07 Typical High $5.50 | Professional | None | $2.75 | $4.07 | $5.50 |
Wellpoint Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
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 $0.81 Median $0.87 Typical High $1.07 | Professional | 55 · Aftercare only | $0.81 | $0.87 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.59 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.54 | $0.59 | $0.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.87 Typical High $1.07 | Professional | 55 · Aftercare only | $0.81 | $0.87 | $1.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.59 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.54 | $0.59 | $0.72 |
Where Texas sits
The same service costs 4.2 times more in Hawaii 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· 22nd of 51
$5.75
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.