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 $8.91 Median $8.91 Typical High $9.77 | Facility | None | $8.91 | $8.91 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $9.12 Typical High $11.22 | Professional | None | $8.32 | $9.12 | $11.22 |
Ambetter Setting Professional Modifier None Typical Low $6.92 Median $8.51 Typical High $9.12 | Professional | None | $6.92 | $8.51 | $9.12 |
BCBS Texas Setting Facility Modifier None Typical Low $10.00 Median $14.45 Typical High $38.90 | Facility | None | $10.00 | $14.45 | $38.90 |
BCBS Texas Setting Professional Modifier None Typical Low $6.61 Median $7.41 Typical High $7.41 | Professional | None | $6.61 | $7.41 | $7.41 |
Christus Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $8.32 | Professional | None | $7.08 | $7.08 | $8.32 |
Lucent Health Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $104.71 | Professional | None | $70.79 | $104.71 | $104.71 |
Moda Health Setting Facility Modifier None Typical Low $3.80 Median $8.91 Typical High $14.13 | Facility | None | $3.80 | $8.91 | $14.13 |
Moda Health Setting Professional Modifier None Typical Low $8.32 Median $9.12 Typical High $12.02 | Professional | None | $8.32 | $9.12 | $12.02 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $81.28 | Professional | None | $9.77 | $9.77 | $81.28 |
Providence Setting Facility Modifier None Typical Low $5.89 Median $8.32 Typical High $14.13 | Facility | None | $5.89 | $8.32 | $14.13 |
Providence Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $8.32 | Professional | None | $7.08 | $7.08 | $8.32 |
United Setting Professional Modifier None Typical Low $4.47 Median $6.17 Typical High $8.32 | Professional | None | $4.47 | $6.17 | $8.32 |
Wellpoint Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
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 $1.26 Median $1.35 Typical High $1.70 | Professional | 55 · Aftercare only | $1.26 | $1.35 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.91 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.83 | $0.91 | $1.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.26 Median $1.35 Typical High $1.70 | Professional | 55 · Aftercare only | $1.26 | $1.35 | $1.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.91 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.83 | $0.91 | $1.12 |
Where Texas sits
The same service costs 2.1 times more in Idaho than in Delaware. 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· 33rd of 51
$8.32
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.