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 $3.80 Median $3.80 Typical High $4.17 | Facility | None | $3.80 | $3.80 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.89 Typical High $4.79 | Professional | None | $3.55 | $3.89 | $4.79 |
BCBS Texas Setting Facility Modifier None Typical Low $3.09 Median $3.31 Typical High $3.72 | Facility | None | $3.09 | $3.31 | $3.72 |
BCBS Texas Setting Professional Modifier None Typical Low $2.82 Median $3.16 Typical High $3.16 | Professional | None | $2.82 | $3.16 | $3.16 |
Christus Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $3.24 | Professional | None | $2.45 | $3.24 | $3.24 |
Lucent Health Setting Professional Modifier None Typical Low $29.51 Median $44.67 Typical High $44.67 | Professional | None | $29.51 | $44.67 | $44.67 |
Moda Health Setting Facility Modifier None Typical Low $1.58 Median $3.80 Typical High $6.03 | Facility | None | $1.58 | $3.80 | $6.03 |
Moda Health Setting Professional Modifier None Typical Low $3.55 Median $3.89 Typical High $5.13 | Professional | None | $3.55 | $3.89 | $5.13 |
Molina Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $81.28 | Professional | None | $3.98 | $3.98 | $81.28 |
Providence Setting Facility Modifier None Typical Low $2.51 Median $3.80 Typical High $6.03 | Facility | None | $2.51 | $3.80 | $6.03 |
Providence Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $3.24 | Professional | None | $2.45 | $3.24 | $3.24 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.63 Typical High $3.55 | Professional | None | $1.91 | $2.63 | $3.55 |
Wellpoint Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
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 $0.52 Median $0.58 Typical High $0.76 | Professional | 55 · Aftercare only | $0.52 | $0.58 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.39 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.35 | $0.39 | $0.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.58 Typical High $0.72 | Professional | 55 · Aftercare only | $0.52 | $0.58 | $0.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.39 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.35 | $0.39 | $0.48 |
Where Texas sits
The same service costs 3.2 times more in Kansas 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· 31st of 51
$3.24
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.