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 $10.72 Median $10.72 Typical High $11.75 | Facility | None | $10.72 | $10.72 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $13.49 | Professional | None | $10.00 | $10.96 | $13.49 |
BCBS Texas Setting Facility Modifier None Typical Low $8.71 Median $9.55 Typical High $10.72 | Facility | None | $8.71 | $9.55 | $10.72 |
BCBS Texas Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
Christus Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | None | $8.51 | $8.51 | $10.00 |
Lucent Health Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $107.15 | Professional | None | $85.11 | $107.15 | $107.15 |
Moda Health Setting Facility Modifier None Typical Low $4.57 Median $10.72 Typical High $16.98 | Facility | None | $4.57 | $10.72 | $16.98 |
Moda Health Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $14.45 | Professional | None | $10.00 | $10.96 | $14.45 |
Molina Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $81.28 | Professional | None | $9.55 | $9.55 | $81.28 |
Providence Setting Facility Modifier None Typical Low $7.08 Median $10.00 Typical High $16.98 | Facility | None | $7.08 | $10.00 | $16.98 |
Providence Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | None | $8.51 | $8.51 | $10.00 |
United Setting Professional Modifier None Typical Low $5.37 Median $7.24 Typical High $10.00 | Professional | None | $5.37 | $7.24 | $10.00 |
Wellpoint Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
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 $1.51 Median $1.62 Typical High $2.00 | Professional | 55 · Aftercare only | $1.51 | $1.62 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.10 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.00 | $1.10 | $1.35 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.62 Typical High $2.00 | Professional | 55 · Aftercare only | $1.51 | $1.62 | $2.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.10 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.00 | $1.10 | $1.35 |
Where Texas sits
The same service costs 2.3 times more in Montana 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· 25th of 51
$10.00
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.