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 $6.61 Median $7.94 Typical High $8.71 | Facility | None | $6.61 | $7.94 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $7.94 Typical High $10.00 | Professional | None | $7.41 | $7.94 | $10.00 |
Ambetter Setting Professional Modifier None Typical Low $7.08 Median $7.41 Typical High $9.33 | Professional | None | $7.08 | $7.41 | $9.33 |
BCBS Texas Setting Facility Modifier None Typical Low $8.91 Median $12.59 Typical High $34.67 | Facility | None | $8.91 | $12.59 | $34.67 |
BCBS Texas Setting Professional Modifier None Typical Low $5.89 Median $6.61 Typical High $6.61 | Professional | None | $5.89 | $6.61 | $6.61 |
Christus Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.76 | Facility | None | $7.41 | $7.41 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.41 | Professional | None | $6.31 | $6.31 | $7.41 |
Lucent Health Setting Professional Modifier None Typical Low $61.66 Median $93.33 Typical High $93.33 | Professional | None | $61.66 | $93.33 | $93.33 |
Moda Health Setting Facility Modifier None Typical Low $3.39 Median $7.94 Typical High $12.59 | Facility | None | $3.39 | $7.94 | $12.59 |
Moda Health Setting Professional Modifier None Typical Low $7.24 Median $8.13 Typical High $10.72 | Professional | None | $7.24 | $8.13 | $10.72 |
Molina Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $81.28 | Professional | None | $9.12 | $9.12 | $81.28 |
Providence Setting Facility Modifier None Typical Low $5.25 Median $7.41 Typical High $12.59 | Facility | None | $5.25 | $7.41 | $12.59 |
Providence Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.41 | Professional | None | $6.31 | $6.31 | $7.41 |
United Setting Professional Modifier None Typical Low $3.98 Median $5.50 Typical High $7.41 | Professional | None | $3.98 | $5.50 | $7.41 |
Wellpoint Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
5 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 $1.20 Typical High $1.51 | Professional | 55 · Aftercare only | $1.12 | $1.20 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.74 Median $0.79 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.74 | $0.79 | $1.00 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | KX · Policy requirements met | $8.71 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.20 Typical High $1.51 | Professional | 55 · Aftercare only | $1.12 | $1.20 | $1.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.74 Median $0.79 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.74 | $0.79 | $1.00 |
Where Texas sits
The same service costs 2.0 times more in Montana than in Florida. 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
$7.94
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.