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 $5.37 Median $5.37 Typical High $5.89 | Facility | None | $5.37 | $5.37 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $5.50 Typical High $6.76 | Professional | None | $5.01 | $5.50 | $6.76 |
BCBS Texas Setting Facility Modifier None Typical Low $6.03 Median $10.23 Typical High $22.91 | Facility | None | $6.03 | $10.23 | $22.91 |
BCBS Texas Setting Professional Modifier None Typical Low $3.98 Median $4.47 Typical High $4.47 | Professional | None | $3.98 | $4.47 | $4.47 |
Christus Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.37 | Facility | None | $5.01 | $5.01 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.01 | Professional | None | $4.27 | $4.27 | $5.01 |
Lucent Health Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $64.57 | Professional | None | $42.66 | $64.57 | $64.57 |
Moda Health Setting Facility Modifier None Typical Low $2.29 Median $5.50 Typical High $8.51 | Facility | None | $2.29 | $5.50 | $8.51 |
Moda Health Setting Professional Modifier None Typical Low $5.01 Median $5.50 Typical High $7.24 | Professional | None | $5.01 | $5.50 | $7.24 |
Molina Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $81.28 | Professional | None | $6.31 | $6.31 | $81.28 |
Providence Setting Facility Modifier None Typical Low $3.63 Median $5.01 Typical High $8.51 | Facility | None | $3.63 | $5.01 | $8.51 |
Providence Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.01 | Professional | None | $4.27 | $4.27 | $5.01 |
United Setting Professional Modifier None Typical Low $2.75 Median $3.72 Typical High $5.13 | Professional | None | $2.75 | $3.72 | $5.13 |
Wellpoint Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
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 $0.76 Median $0.83 Typical High $1.02 | Professional | 55 · Aftercare only | $0.76 | $0.83 | $1.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.55 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.51 | $0.55 | $0.71 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | KX · Policy requirements met | $6.03 | $6.03 | $6.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.83 Typical High $1.02 | Professional | 55 · Aftercare only | $0.76 | $0.83 | $1.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.55 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.51 | $0.55 | $0.68 |
Where Texas sits
The same service costs 2.1 times more in Hawaii 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· 31st of 51
$5.13
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.