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 $44.67 Median $44.67 Typical High $48.98 | Facility | None | $44.67 | $44.67 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $52.48 | Professional | None | $41.69 | $44.67 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
BCBS Texas Setting Facility Modifier None Typical Low $36.31 Median $54.95 Typical High $56.23 | Facility | None | $36.31 | $54.95 | $56.23 |
BCBS Texas Setting Professional Modifier None Typical Low $32.36 Median $36.31 Typical High $36.31 | Professional | None | $32.36 | $36.31 | $36.31 |
Christus Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | None | $34.67 | $34.67 | $40.74 |
Lucent Health Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | None | $371.54 | $446.68 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $18.62 Median $44.67 Typical High $69.18 | Facility | None | $18.62 | $44.67 | $69.18 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $58.88 | Professional | None | $41.69 | $44.67 | $58.88 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $81.28 | Professional | None | $46.77 | $46.77 | $81.28 |
Providence Setting Facility Modifier None Typical Low $29.51 Median $40.74 Typical High $69.18 | Facility | None | $29.51 | $40.74 | $69.18 |
Providence Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | None | $34.67 | $34.67 | $40.74 |
United Setting Professional Modifier None Typical Low $22.39 Median $29.51 Typical High $41.69 | Professional | None | $22.39 | $29.51 | $41.69 |
Wellpoint Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
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 $6.17 Median $6.76 Typical High $7.76 | Professional | 55 · Aftercare only | $6.17 | $6.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.47 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.17 | $4.47 | $5.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.76 Typical High $8.32 | Professional | 55 · Aftercare only | $6.17 | $6.76 | $8.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.47 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.17 | $4.47 | $5.50 |
Where Texas sits
The same service costs 3.0 times more in Hawaii than in Rhode Island. 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· 31st of 51
$40.74
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.