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 $1.51 Median $1.51 Typical High $1.66 | Facility | None | $1.51 | $1.51 | $1.66 |
Aetna Setting Professional Modifier None Typical Low $1.41 Median $1.55 Typical High $1.91 | Professional | None | $1.41 | $1.55 | $1.91 |
Ambetter Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | None | $1.55 | $1.55 | $1.55 |
BCBS Texas Setting Facility Modifier None Typical Low $1.23 Median $1.35 Typical High $1.51 | Facility | None | $1.23 | $1.35 | $1.51 |
BCBS Texas Setting Professional Modifier None Typical Low $1.12 Median $1.26 Typical High $1.26 | Professional | None | $1.12 | $1.26 | $1.26 |
Christus Setting Facility Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | None | $2.40 | $2.40 | $2.40 |
Cigna Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.74 | Facility | None | $1.41 | $1.41 | $1.74 |
Cigna Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.41 | Professional | None | $1.20 | $1.20 | $1.41 |
Lucent Health Setting Professional Modifier None Typical Low $12.02 Median $17.78 Typical High $17.78 | Professional | None | $12.02 | $17.78 | $17.78 |
Moda Health Setting Facility Modifier None Typical Low $0.65 Median $1.51 Typical High $2.40 | Facility | None | $0.65 | $1.51 | $2.40 |
Moda Health Setting Professional Modifier None Typical Low $1.41 Median $1.55 Typical High $2.04 | Professional | None | $1.41 | $1.55 | $2.04 |
Molina Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $81.28 | Professional | None | $1.55 | $1.55 | $81.28 |
Providence Setting Facility Modifier None Typical Low $1.00 Median $1.41 Typical High $2.40 | Facility | None | $1.00 | $1.41 | $2.40 |
Providence Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.41 | Professional | None | $1.20 | $1.20 | $1.41 |
United Setting Professional Modifier None Typical Low $0.78 Median $1.02 Typical High $1.45 | Professional | None | $0.78 | $1.02 | $1.45 |
Wellpoint Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
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 $0.21 Median $0.23 Typical High $0.28 | Professional | 55 · Aftercare only | $0.21 | $0.23 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.15 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.14 | $0.15 | $0.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.23 Typical High $0.28 | Professional | 55 · Aftercare only | $0.21 | $0.23 | $0.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.15 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.14 | $0.15 | $0.19 |
Where Texas sits
The same service costs 5.4 times more in Kansas than in Kentucky. 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· 32nd of 51
$1.41
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.