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 $4.47 Median $4.47 Typical High $4.90 | Facility | None | $4.47 | $4.47 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.47 Typical High $5.62 | Professional | None | $4.17 | $4.47 | $5.62 |
Ambetter Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
BCBS Texas Setting Facility Modifier None Typical Low $5.37 Median $7.76 Typical High $19.50 | Facility | None | $5.37 | $7.76 | $19.50 |
BCBS Texas Setting Professional Modifier None Typical Low $3.24 Median $3.63 Typical High $3.63 | Professional | None | $3.24 | $3.63 | $3.63 |
Christus Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.47 | Facility | None | $4.17 | $4.17 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.17 | Professional | None | $3.55 | $3.55 | $4.17 |
Lucent Health Setting Professional Modifier None Typical Low $34.67 Median $52.48 Typical High $52.48 | Professional | None | $34.67 | $52.48 | $52.48 |
Moda Health Setting Facility Modifier None Typical Low $1.91 Median $4.57 Typical High $7.08 | Facility | None | $1.91 | $4.57 | $7.08 |
Moda Health Setting Professional Modifier None Typical Low $4.17 Median $4.57 Typical High $6.03 | Professional | None | $4.17 | $4.57 | $6.03 |
Molina Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $81.28 | Professional | None | $5.13 | $5.13 | $81.28 |
Providence Setting Facility Modifier None Typical Low $2.95 Median $4.17 Typical High $7.08 | Facility | None | $2.95 | $4.17 | $7.08 |
Providence Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.17 | Professional | None | $3.55 | $3.55 | $4.17 |
United Setting Professional Modifier None Typical Low $2.24 Median $3.09 Typical High $4.17 | Professional | None | $2.24 | $3.09 | $4.17 |
Wellpoint Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
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 $0.62 Median $0.68 Typical High $0.83 | Professional | 55 · Aftercare only | $0.62 | $0.68 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.45 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.42 | $0.45 | $0.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.68 Typical High $0.83 | Professional | 55 · Aftercare only | $0.62 | $0.68 | $0.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.45 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.42 | $0.45 | $0.56 |
Where Texas sits
The same service costs 2.1 times more in Kansas than in Colorado. 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· 28th of 51
$4.47
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.