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 $1.10 Median $1.10 Typical High $1.20 | Facility | None | $1.10 | $1.10 | $1.20 |
Aetna Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.45 | Professional | None | $1.02 | $1.12 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.17 Typical High $0.22 | Professional | 55 · Aftercare only | $0.15 | $0.17 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.11 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.10 | $0.11 | $0.14 |
Ambetter Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | None | $1.20 | $1.20 | $1.20 |
BCBS Texas Setting Facility Modifier None Typical Low $1.38 Median $1.91 Typical High $4.79 | Facility | None | $1.38 | $1.91 | $4.79 |
BCBS Texas Setting Professional Modifier None Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | None | $0.81 | $0.81 | $0.81 |
Christus Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Lucent Health Setting Professional Modifier None Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | None | $10.00 | $12.88 | $12.88 |
Moda Health Setting Facility Modifier None Typical Low $1.10 Median $1.58 Typical High $1.78 | Facility | None | $1.10 | $1.58 | $1.78 |
Moda Health Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.48 | Professional | None | $1.02 | $1.12 | $1.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.17 Typical High $0.21 | Professional | 55 · Aftercare only | $0.15 | $0.17 | $0.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.11 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.10 | $0.11 | $0.14 |
Molina Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.41 | Professional | None | $1.23 | $1.23 | $1.41 |
Providence Setting Facility Modifier None Typical Low $1.12 Median $1.74 Typical High $1.78 | Facility | None | $1.12 | $1.74 | $1.78 |
Providence Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
United Setting Professional Modifier None Typical Low $0.71 Median $0.91 Typical High $1.23 | Professional | None | $0.71 | $0.91 | $1.23 |
Wellpoint Setting Professional Modifier None Typical Low $0.74 Median $0.74 Typical High $0.74 | Professional | None | $0.74 | $0.74 | $0.74 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | KX · Policy requirements met | $1.20 | $1.20 | $1.20 |
Where Texas sits
The same service costs 3.1 times more in Hawaii than in Utah. 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· 36th of 51
$1.02
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.