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 $6.31 Median $6.31 Typical High $6.92 | Facility | None | $6.31 | $6.31 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $6.46 Typical High $7.94 | Professional | None | $5.89 | $6.46 | $7.94 |
Ambetter Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
BCBS Texas Setting Facility Modifier None Typical Low $7.76 Median $11.22 Typical High $27.54 | Facility | None | $7.76 | $11.22 | $27.54 |
BCBS Texas Setting Professional Modifier None Typical Low $4.68 Median $5.25 Typical High $5.25 | Professional | None | $4.68 | $5.25 | $5.25 |
Christus Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $7.24 | Facility | None | $5.89 | $5.89 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.89 | Professional | None | $5.01 | $5.01 | $5.89 |
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 $50.12 Median $74.13 Typical High $74.13 | Professional | None | $50.12 | $74.13 | $74.13 |
Moda Health Setting Facility Modifier None Typical Low $2.69 Median $6.31 Typical High $10.00 | Facility | None | $2.69 | $6.31 | $10.00 |
Moda Health Setting Professional Modifier None Typical Low $5.89 Median $6.46 Typical High $8.51 | Professional | None | $5.89 | $6.46 | $8.51 |
Molina Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $81.28 | Professional | None | $6.61 | $6.61 | $81.28 |
Providence Setting Facility Modifier None Typical Low $4.17 Median $5.89 Typical High $10.00 | Facility | None | $4.17 | $5.89 | $10.00 |
Providence Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.89 | Professional | None | $5.01 | $5.01 | $5.89 |
United Setting Professional Modifier None Typical Low $3.09 Median $4.47 Typical High $5.89 | Professional | None | $3.09 | $4.47 | $5.89 |
Wellpoint Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $4.17 | Professional | None | $3.80 | $3.80 | $4.17 |
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 $0.89 Median $0.95 Typical High $1.20 | Professional | 55 · Aftercare only | $0.89 | $0.95 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.65 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.59 | $0.65 | $0.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $0.95 Typical High $1.20 | Professional | 55 · Aftercare only | $0.89 | $0.95 | $1.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.65 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.59 | $0.65 | $0.79 |
Where Texas sits
The same service costs 2.4 times more in Kansas 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· 22nd of 51
$6.46
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.