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 $13.49 Median $13.49 Typical High $14.79 | Facility | None | $13.49 | $13.49 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $13.80 Typical High $16.98 | Professional | None | $12.59 | $13.80 | $16.98 |
BCBS Texas Setting Facility Modifier None Typical Low $10.96 Median $12.02 Typical High $13.49 | Facility | None | $10.96 | $12.02 | $13.49 |
Christus Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $11.75 | Professional | None | $8.71 | $11.75 | $11.75 |
Lucent Health Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $162.18 | Professional | None | $107.15 | $162.18 | $162.18 |
Moda Health Setting Facility Modifier None Typical Low $5.75 Median $13.49 Typical High $21.38 | Facility | None | $5.75 | $13.49 | $21.38 |
Moda Health Setting Professional Modifier None Typical Low $12.59 Median $13.80 Typical High $18.20 | Professional | None | $12.59 | $13.80 | $18.20 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $81.28 | Professional | None | $14.45 | $14.45 | $81.28 |
Providence Setting Facility Modifier None Typical Low $8.91 Median $13.80 Typical High $21.38 | Facility | None | $8.91 | $13.80 | $21.38 |
Providence Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $11.75 | Professional | None | $8.71 | $11.75 | $11.75 |
United Setting Professional Modifier None Typical Low $6.92 Median $9.33 Typical High $12.88 | Professional | None | $6.92 | $9.33 | $12.88 |
Wellpoint Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
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 $1.91 Median $2.04 Typical High $2.57 | Professional | 55 · Aftercare only | $1.91 | $2.04 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.38 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.26 | $1.38 | $1.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $2.09 Typical High $2.57 | Professional | 55 · Aftercare only | $1.91 | $2.09 | $2.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.38 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.26 | $1.38 | $1.70 |
Where Texas sits
The same service costs 2.3 times more in Hawaii than in Connecticut. 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
$11.75
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.