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 $0.52 Median $0.52 Typical High $0.59 | Facility | None | $0.52 | $0.52 | $0.59 |
Aetna Setting Professional Modifier None Typical Low $0.46 Median $0.52 Typical High $0.71 | Professional | None | $0.46 | $0.52 | $0.71 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
BCBS Texas Setting Facility Modifier None Typical Low $0.60 Median $0.60 Typical High $0.79 | Facility | None | $0.60 | $0.60 | $0.79 |
BCBS Texas Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Christus Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Lucent Health Setting Professional Modifier None Typical Low $5.50 Median $5.89 Typical High $5.89 | Professional | None | $5.50 | $5.89 | $5.89 |
Moda Health Setting Facility Modifier None Typical Low $0.52 Median $0.72 Typical High $0.98 | Facility | None | $0.52 | $0.72 | $0.98 |
Moda Health Setting Professional Modifier None Typical Low $0.46 Median $0.52 Typical High $0.65 | Professional | None | $0.46 | $0.52 | $0.65 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $0.52 Median $0.76 Typical High $0.91 | Facility | None | $0.52 | $0.76 | $0.91 |
Providence Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.43 Typical High $0.76 | Professional | None | $0.36 | $0.43 | $0.76 |
Wellpoint Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | None | $0.30 | $0.30 | $0.30 |
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 $0.07 Median $0.08 Typical High $0.09 | Professional | 55 · Aftercare only | $0.07 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.06 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | Q6 · Substitute physician, paid per time | $1.51 | $1.51 | $1.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.08 Typical High $0.09 | Professional | 55 · Aftercare only | $0.07 | $0.08 | $0.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.06 |
Where Texas sits
The same service costs 2.9 times more in Minnesota than in Ohio. 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· 5th of 51
$1.12
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.