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 $8.13 Median $8.13 Typical High $8.91 | Facility | None | $8.13 | $8.13 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $8.32 Typical High $10.23 | Professional | None | $7.59 | $8.32 | $10.23 |
BCBS Texas Setting Facility Modifier None Typical Low $9.12 Median $13.18 Typical High $35.48 | Facility | None | $9.12 | $13.18 | $35.48 |
BCBS Texas Setting Professional Modifier None Typical Low $6.03 Median $6.76 Typical High $6.76 | Professional | None | $6.03 | $6.76 | $6.76 |
Christus Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.94 | Facility | None | $7.59 | $7.59 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | None | $6.46 | $6.46 | $7.59 |
Lucent Health Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $95.50 | Professional | None | $64.57 | $95.50 | $95.50 |
Moda Health Setting Facility Modifier None Typical Low $3.47 Median $7.59 Typical High $12.88 | Facility | None | $3.47 | $7.59 | $12.88 |
Moda Health Setting Professional Modifier None Typical Low $7.59 Median $8.32 Typical High $10.96 | Professional | None | $7.59 | $8.32 | $10.96 |
Molina Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $81.28 | Professional | None | $8.71 | $8.71 | $81.28 |
Providence Setting Facility Modifier None Typical Low $5.37 Median $7.59 Typical High $12.88 | Facility | None | $5.37 | $7.59 | $12.88 |
Providence Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | None | $6.46 | $6.46 | $7.59 |
United Setting Professional Modifier None Typical Low $4.17 Median $5.62 Typical High $7.76 | Professional | None | $4.17 | $5.62 | $7.76 |
Wellpoint Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
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 $1.12 Median $1.26 Typical High $1.55 | Professional | 55 · Aftercare only | $1.12 | $1.26 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $0.83 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.76 | $0.83 | $1.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $1.26 Typical High $1.55 | Professional | 55 · Aftercare only | $1.15 | $1.26 | $1.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $0.83 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.76 | $0.83 | $1.02 |
Where Texas sits
The same service costs 2.1 times more in Idaho 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· 28th of 51
$7.76
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.