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 $25.70 Median $25.70 Typical High $28.18 | Facility | None | $25.70 | $25.70 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $25.70 Typical High $32.36 | Professional | None | $23.99 | $25.70 | $32.36 |
Ambetter Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
BCBS Texas Setting Facility Modifier None Typical Low $20.89 Median $22.39 Typical High $25.12 | Facility | None | $20.89 | $22.39 | $25.12 |
BCBS Texas Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Christus 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 Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $22.39 | Professional | None | $16.22 | $22.39 | $22.39 |
Lucent Health Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $302.00 | Professional | None | $199.53 | $302.00 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $10.72 Median $25.70 Typical High $39.81 | Facility | None | $10.72 | $25.70 | $39.81 |
Moda Health Setting Professional Modifier None Typical Low $23.99 Median $25.70 Typical High $33.88 | Professional | None | $23.99 | $25.70 | $33.88 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $81.28 | Professional | None | $26.92 | $26.92 | $81.28 |
Providence Setting Facility Modifier None Typical Low $16.98 Median $26.30 Typical High $39.81 | Facility | None | $16.98 | $26.30 | $39.81 |
Providence Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $22.39 | Professional | None | $16.22 | $22.39 | $22.39 |
United Setting Professional Modifier None Typical Low $12.88 Median $17.78 Typical High $23.99 | Professional | None | $12.88 | $17.78 | $23.99 |
Wellpoint Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
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 $3.55 Median $3.89 Typical High $4.79 | Professional | 55 · Aftercare only | $3.55 | $3.89 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.57 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.40 | $2.57 | $3.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.89 Typical High $4.79 | Professional | 55 · Aftercare only | $3.55 | $3.89 | $4.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.57 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.40 | $2.57 | $3.24 |
Where Texas sits
The same service costs 3.0 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· 35th of 51
$22.39
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.