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 $0.26 Median $0.26 Typical High $0.30 | Facility | None | $0.26 | $0.26 | $0.30 |
Aetna Setting Professional Modifier None Typical Low $0.23 Median $0.26 Typical High $0.30 | Professional | None | $0.23 | $0.26 | $0.30 |
Ambetter Setting Professional Modifier None Typical Low $18.20 Median $25.70 Typical High $25.70 | Professional | None | $18.20 | $25.70 | $25.70 |
BCBS Texas Setting Facility Modifier None Typical Low $0.18 Median $0.31 Typical High $0.89 | Facility | None | $0.18 | $0.31 | $0.89 |
BCBS Texas Setting Professional Modifier None Typical Low $0.16 Median $0.18 Typical High $0.18 | Professional | None | $0.16 | $0.18 | $0.18 |
Christus Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $0.19 Median $0.20 Typical High $0.25 | Facility | None | $0.19 | $0.20 | $0.25 |
Cigna Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $0.20 | Professional | None | $0.17 | $0.17 | $0.20 |
Lucent Health Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $1.29 | Professional | None | $0.91 | $0.91 | $1.29 |
Moda Health Setting Facility Modifier None Typical Low $0.17 Median $0.24 Typical High $0.35 | Facility | None | $0.17 | $0.24 | $0.35 |
Moda Health Setting Professional Modifier None Typical Low $0.23 Median $0.26 Typical High $0.30 | Professional | None | $0.23 | $0.26 | $0.30 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Providence Setting Facility Modifier None Typical Low $0.18 Median $0.20 Typical High $0.35 | Facility | None | $0.18 | $0.20 | $0.35 |
Providence Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $0.20 | Professional | None | $0.17 | $0.17 | $0.20 |
United Setting Professional Modifier None Typical Low $0.11 Median $0.15 Typical High $0.21 | Professional | None | $0.11 | $0.15 | $0.21 |
Wellpoint Setting Professional Modifier None Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | None | $0.18 | $0.18 | $0.18 |
3 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | AU · Urologic/ostomy supply | $25.12 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.21 Median $0.30 Typical High $0.43 | Professional | AU · Urologic/ostomy supply | $0.21 | $0.30 | $0.43 |
Moda Health Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.21 Median $0.30 Typical High $0.38 | Professional | AV · With prosthetic/orthotic | $0.21 | $0.30 | $0.38 |
Where Texas sits
The same service costs 2.7 times more in Arkansas 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· 25th of 51
$0.23
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.