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 $7.41 Median $7.41 Typical High $8.13 | Facility | None | $7.41 | $7.41 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $7.59 Typical High $9.33 | Professional | None | $6.92 | $7.59 | $9.33 |
Ambetter Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
BCBS Texas Setting Facility Modifier None Typical Low $8.32 Median $11.75 Typical High $32.36 | Facility | None | $8.32 | $11.75 | $32.36 |
BCBS Texas Setting Professional Modifier None Typical Low $5.50 Median $6.17 Typical High $6.17 | Professional | None | $5.50 | $6.17 | $6.17 |
Christus Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $7.59 | Facility | None | $6.92 | $6.92 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $6.92 | Professional | None | $5.89 | $5.89 | $6.92 |
Lucent Health Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $87.10 | Professional | None | $57.54 | $87.10 | $87.10 |
Moda Health Setting Facility Modifier None Typical Low $3.16 Median $6.92 Typical High $11.75 | Facility | None | $3.16 | $6.92 | $11.75 |
Moda Health Setting Professional Modifier None Typical Low $6.92 Median $7.59 Typical High $10.00 | Professional | None | $6.92 | $7.59 | $10.00 |
Molina Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $81.28 | Professional | None | $6.31 | $6.31 | $81.28 |
Providence Setting Facility Modifier None Typical Low $4.90 Median $6.92 Typical High $11.75 | Facility | None | $4.90 | $6.92 | $11.75 |
Providence Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $6.92 | Professional | None | $5.89 | $5.89 | $6.92 |
United Setting Professional Modifier None Typical Low $3.72 Median $5.13 Typical High $6.92 | Professional | None | $3.72 | $5.13 | $6.92 |
Wellpoint Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
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 $1.05 Median $1.12 Typical High $1.41 | Professional | 55 · Aftercare only | $1.05 | $1.12 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.69 Median $0.76 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.69 | $0.76 | $0.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.05 Median $1.12 Typical High $1.41 | Professional | 55 · Aftercare only | $1.05 | $1.12 | $1.41 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.69 Median $0.76 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.69 | $0.76 | $0.93 |
Where Texas sits
The same service costs 2.1 times more in Idaho than in Colorado. 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· 30th of 51
$6.92
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.