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 $4.17 Median $4.17 Typical High $4.57 | Facility | None | $4.17 | $4.17 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $4.27 Typical High $5.25 | Professional | None | $3.89 | $4.27 | $5.25 |
BCBS Texas Setting Facility Modifier None Typical Low $3.39 Median $3.72 Typical High $4.07 | Facility | None | $3.39 | $3.72 | $4.07 |
BCBS Texas Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
Christus Setting Facility Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.89 | Professional | None | $3.31 | $3.31 | $3.89 |
Lucent Health Setting Professional Modifier None Typical Low $33.11 Median $48.98 Typical High $48.98 | Professional | None | $33.11 | $48.98 | $48.98 |
Moda Health Setting Facility Modifier None Typical Low $1.78 Median $4.17 Typical High $6.61 | Facility | None | $1.78 | $4.17 | $6.61 |
Moda Health Setting Professional Modifier None Typical Low $3.89 Median $4.27 Typical High $5.62 | Professional | None | $3.89 | $4.27 | $5.62 |
Molina Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $81.28 | Professional | None | $4.37 | $4.37 | $81.28 |
Providence Setting Facility Modifier None Typical Low $2.75 Median $3.89 Typical High $6.61 | Facility | None | $2.75 | $3.89 | $6.61 |
Providence Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.89 | Professional | None | $3.31 | $3.31 | $3.89 |
United Setting Professional Modifier None Typical Low $2.09 Median $2.88 Typical High $3.89 | Professional | None | $2.09 | $2.88 | $3.89 |
Wellpoint Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
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 $0.59 Median $0.65 Typical High $0.81 | Professional | 55 · Aftercare only | $0.59 | $0.65 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.43 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.39 | $0.43 | $0.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.65 Typical High $0.79 | Professional | 55 · Aftercare only | $0.59 | $0.65 | $0.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.43 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.39 | $0.43 | $0.52 |
Where Texas sits
The same service costs 2.6 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· 27th of 51
$3.98
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.