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 $2.88 Median $2.88 Typical High $3.16 | Facility | None | $2.88 | $2.88 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $2.95 Typical High $3.63 | Professional | None | $2.69 | $2.95 | $3.63 |
Ambetter Setting Professional Modifier None Typical Low $2.34 Median $2.95 Typical High $3.09 | Professional | None | $2.34 | $2.95 | $3.09 |
BCBS Texas Setting Facility Modifier None Typical Low $3.47 Median $5.13 Typical High $12.59 | Facility | None | $3.47 | $5.13 | $12.59 |
BCBS Texas Setting Professional Modifier None Typical Low $2.14 Median $2.40 Typical High $2.40 | Professional | None | $2.14 | $2.40 | $2.40 |
Christus Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $3.09 | Facility | None | $2.95 | $2.95 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | None | $2.45 | $2.45 | $2.95 |
Lucent Health Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $37.15 | Professional | None | $24.55 | $37.15 | $37.15 |
Moda Health Setting Facility Modifier None Typical Low $1.32 Median $2.51 Typical High $4.57 | Facility | None | $1.32 | $2.51 | $4.57 |
Moda Health Setting Professional Modifier None Typical Low $2.69 Median $2.95 Typical High $3.89 | Professional | None | $2.69 | $2.95 | $3.89 |
Molina Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $81.28 | Professional | None | $2.63 | $2.63 | $81.28 |
Providence Setting Facility Modifier None Typical Low $1.95 Median $2.95 Typical High $4.57 | Facility | None | $1.95 | $2.95 | $4.57 |
Providence Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | None | $2.45 | $2.45 | $2.95 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.14 Typical High $2.95 | Professional | None | $1.58 | $2.14 | $2.95 |
Wellpoint Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
5 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 $0.41 Median $0.44 Typical High $0.56 | Professional | 55 · Aftercare only | $0.41 | $0.44 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.28 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.27 | $0.28 | $0.38 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | KX · Policy requirements met | $3.16 | $3.16 | $3.16 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.41 Median $0.44 Typical High $0.58 | Professional | 55 · Aftercare only | $0.41 | $0.44 | $0.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.29 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.27 | $0.29 | $0.38 |
Where Texas sits
The same service costs 5.5 times more in Kansas than in Delaware. 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
$2.95
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.