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 $42.66 Median $42.66 Typical High $46.77 | Facility | None | $42.66 | $42.66 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $53.70 | Professional | None | $39.81 | $43.65 | $53.70 |
BCBS Texas Setting Facility Modifier None Typical Low $34.67 Median $38.02 Typical High $42.66 | Facility | None | $34.67 | $38.02 | $42.66 |
BCBS Texas Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Christus Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
Lucent Health Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $512.86 | Professional | None | $338.84 | $512.86 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $18.20 Median $42.66 Typical High $67.61 | Facility | None | $18.20 | $42.66 | $67.61 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $57.54 | Professional | None | $39.81 | $43.65 | $57.54 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $81.28 | Professional | None | $45.71 | $45.71 | $81.28 |
Providence Setting Facility Modifier None Typical Low $28.84 Median $39.81 Typical High $67.61 | Facility | None | $28.84 | $39.81 | $67.61 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
United Setting Professional Modifier None Typical Low $21.88 Median $29.51 Typical High $40.74 | Professional | None | $21.88 | $29.51 | $40.74 |
Wellpoint Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $6.03 Median $6.61 Typical High $8.13 | Professional | 55 · Aftercare only | $6.03 | $6.61 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.98 | $4.37 | $5.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.61 Typical High $8.13 | Professional | 55 · Aftercare only | $6.03 | $6.61 | $8.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.98 | $4.37 | $5.37 |
Where Texas sits
The same service costs 5.8 times more in Hawaii than in Kansas. 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· 26th of 51
$41.69
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.