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 $2.19 Median $2.19 Typical High $2.40 | Facility | None | $2.19 | $2.19 | $2.40 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.24 Typical High $2.75 | Professional | None | $2.04 | $2.24 | $2.75 |
Ambetter Setting Professional Modifier None Typical Low $1.82 Median $2.09 Typical High $2.24 | Professional | None | $1.82 | $2.09 | $2.24 |
BCBS Texas Setting Facility Modifier None Typical Low $2.69 Median $3.72 Typical High $9.55 | Facility | None | $2.69 | $3.72 | $9.55 |
BCBS Texas Setting Professional Modifier None Typical Low $1.62 Median $1.82 Typical High $1.82 | Professional | None | $1.62 | $1.82 | $1.82 |
Christus Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $1.82 Median $2.04 Typical High $2.04 | Facility | None | $1.82 | $2.04 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.04 | Professional | None | $1.74 | $1.74 | $2.04 |
Lucent Health Setting Professional Modifier None Typical Low $18.20 Median $25.70 Typical High $25.70 | Professional | None | $18.20 | $25.70 | $25.70 |
Moda Health Setting Facility Modifier None Typical Low $0.93 Median $2.19 Typical High $10.23 | Facility | None | $0.93 | $2.19 | $10.23 |
Moda Health Setting Professional Modifier None Typical Low $2.04 Median $2.24 Typical High $2.95 | Professional | None | $2.04 | $2.24 | $2.95 |
Molina Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $81.28 | Professional | None | $2.29 | $2.29 | $81.28 |
Providence Setting Facility Modifier None Typical Low $1.45 Median $2.04 Typical High $3.47 | Facility | None | $1.45 | $2.04 | $3.47 |
Providence Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.04 | Professional | None | $1.74 | $1.74 | $2.04 |
United Setting Professional Modifier None Typical Low $1.12 Median $1.51 Typical High $2.04 | Professional | None | $1.12 | $1.51 | $2.04 |
Wellpoint Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
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 $0.31 Median $0.33 Typical High $0.41 | Professional | 55 · Aftercare only | $0.31 | $0.33 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.22 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.21 | $0.22 | $0.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.33 Typical High $0.41 | Professional | 55 · Aftercare only | $0.31 | $0.33 | $0.41 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.22 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.21 | $0.22 | $0.27 |
Where Texas sits
The same service costs 3.8 times more in Kansas than in Alabama. 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· 25th of 51
$2.24
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.