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 $1.62 Median $1.62 Typical High $1.78 | Facility | None | $1.62 | $1.62 | $1.78 |
Aetna Setting Professional Modifier None Typical Low $1.51 Median $1.66 Typical High $2.04 | Professional | None | $1.51 | $1.66 | $2.04 |
Ambetter Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
BCBS Texas Setting Facility Modifier None Typical Low $1.86 Median $3.09 Typical High $6.92 | Facility | None | $1.86 | $3.09 | $6.92 |
BCBS Texas Setting Professional Modifier None Typical Low $1.20 Median $1.35 Typical High $1.35 | Professional | None | $1.20 | $1.35 | $1.35 |
Christus Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.58 | Facility | None | $1.51 | $1.51 | $1.58 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.51 | Professional | None | $1.29 | $1.29 | $1.51 |
Lucent Health Setting Professional Modifier None Typical Low $12.88 Median $19.05 Typical High $19.05 | Professional | None | $12.88 | $19.05 | $19.05 |
Moda Health Setting Facility Modifier None Typical Low $0.68 Median $1.62 Typical High $2.57 | Facility | None | $0.68 | $1.62 | $2.57 |
Moda Health Setting Professional Modifier None Typical Low $1.51 Median $1.66 Typical High $2.19 | Professional | None | $1.51 | $1.66 | $2.19 |
Molina Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $81.28 | Professional | None | $1.91 | $1.91 | $81.28 |
Providence Setting Facility Modifier None Typical Low $1.07 Median $1.51 Typical High $2.57 | Facility | None | $1.07 | $1.51 | $2.57 |
Providence Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.51 | Professional | None | $1.29 | $1.29 | $1.51 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.12 Typical High $1.51 | Professional | None | $0.81 | $1.12 | $1.51 |
Wellpoint Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
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 $0.23 Median $0.25 Typical High $0.32 | Professional | 55 · Aftercare only | $0.23 | $0.25 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.17 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.15 | $0.17 | $0.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.25 Typical High $0.31 | Professional | 55 · Aftercare only | $0.23 | $0.25 | $0.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.17 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.15 | $0.17 | $0.21 |
Where Texas sits
The same service costs 2.1 times more in Idaho than in Connecticut. 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· 26th of 51
$1.62
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.