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 $1.45 Median $1.45 Typical High $1.58 | Facility | None | $1.45 | $1.45 | $1.58 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.45 Typical High $1.78 | Professional | None | $1.26 | $1.45 | $1.78 |
Ambetter Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
BCBS Texas Setting Facility Modifier None Typical Low $1.74 Median $2.51 Typical High $6.31 | Facility | None | $1.74 | $2.51 | $6.31 |
BCBS Texas Setting Professional Modifier None Typical Low $1.07 Median $1.20 Typical High $1.20 | Professional | None | $1.07 | $1.20 | $1.20 |
Baylor Scott & White Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $2.29 | Professional | None | $1.70 | $1.70 | $2.29 |
Christus Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $0.72 Median $1.35 Typical High $1.35 | Facility | None | $0.72 | $1.35 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.35 | Professional | None | $1.12 | $1.12 | $1.35 |
Lucent Health Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Moda Health Setting Facility Modifier None Typical Low $0.62 Median $1.45 Typical High $2.29 | Facility | None | $0.62 | $1.45 | $2.29 |
Moda Health Setting Professional Modifier None Typical Low $1.26 Median $1.45 Typical High $1.95 | Professional | None | $1.26 | $1.45 | $1.95 |
Molina Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $81.28 | Professional | None | $1.51 | $1.51 | $81.28 |
Providence Setting Facility Modifier None Typical Low $0.72 Median $1.35 Typical High $2.29 | Facility | None | $0.72 | $1.35 | $2.29 |
Providence Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.35 | Professional | None | $1.12 | $1.12 | $1.35 |
United Setting Professional Modifier None Typical Low $0.72 Median $0.95 Typical High $1.35 | Professional | None | $0.72 | $0.95 | $1.35 |
Wellpoint Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.20 | Professional | None | $1.17 | $1.17 | $1.20 |
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 $0.20 Median $0.22 Typical High $0.27 | Professional | 55 · Aftercare only | $0.20 | $0.22 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.15 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.14 | $0.15 | $0.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.22 Typical High $0.27 | Professional | 55 · Aftercare only | $0.20 | $0.22 | $0.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.15 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.14 | $0.15 | $0.18 |
Where Texas sits
The same service costs 5.8 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· 26th of 51
$1.35
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.