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 $35.48 Median $35.48 Typical High $38.02 | Facility | None | $35.48 | $35.48 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $45.71 | Professional | None | $33.11 | $35.48 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
BCBS Texas Setting Facility Modifier None Typical Low $40.74 Median $61.66 Typical High $144.54 | Facility | None | $40.74 | $61.66 | $144.54 |
BCBS Texas Setting Professional Modifier None Typical Low $25.70 Median $28.84 Typical High $28.84 | Professional | None | $25.70 | $28.84 | $28.84 |
Christus Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $38.02 Typical High $38.02 | Facility | None | $34.67 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
Lucent Health Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $416.87 | Professional | None | $331.13 | $416.87 | $416.87 |
Moda Health Setting Facility Modifier None Typical Low $17.38 Median $35.48 Typical High $54.95 | Facility | None | $17.38 | $35.48 | $54.95 |
Moda Health Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $47.86 | Professional | None | $33.11 | $35.48 | $47.86 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $81.28 | Professional | None | $30.20 | $30.20 | $81.28 |
Providence Setting Facility Modifier None Typical Low $23.44 Median $38.02 Typical High $54.95 | Facility | None | $23.44 | $38.02 | $54.95 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
United Setting Professional Modifier None Typical Low $20.42 Median $29.51 Typical High $38.90 | Professional | None | $20.42 | $29.51 | $38.90 |
Wellpoint Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
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 $4.90 Median $5.37 Typical High $6.92 | Professional | 55 · Aftercare only | $4.90 | $5.37 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.55 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.31 | $3.55 | $4.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.37 Typical High $6.92 | Professional | 55 · Aftercare only | $5.01 | $5.37 | $6.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.55 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.31 | $3.55 | $4.57 |
Where Texas sits
The same service costs 3.0 times more in Hawaii than in New Hampshire. 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· 34th of 51
$36.31
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.