How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $3Professionalmedian $1 · 10th to 90th $0 to $8
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 $0.71 Median $0.71 Typical High $0.78 | Facility | None | $0.71 | $0.71 | $0.78 |
Aetna Setting Professional Modifier None Typical Low $0.66 Median $0.72 Typical High $0.89 | Professional | None | $0.66 | $0.72 | $0.89 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $95.50 | Professional | None | $70.79 | $77.62 | $95.50 |
BCBS Texas Setting Facility Modifier None Typical Low $0.87 Median $1.12 Typical High $2.95 | Facility | None | $0.87 | $1.12 | $2.95 |
BCBS Texas Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | None | $0.52 | $0.52 | $0.52 |
Christus Setting Facility Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Facility | None | $1.91 | $1.91 | $1.91 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Lucent Health Setting Professional Modifier None Typical Low $5.62 Median $8.32 Typical High $8.32 | Professional | None | $5.62 | $8.32 | $8.32 |
Moda Health Setting Facility Modifier None Typical Low $0.81 Median $3.02 Typical High $5,011.87 | Facility | None | $0.81 | $3.02 | $5,011.87 |
Moda Health Setting Professional Modifier None Typical Low $0.66 Median $0.72 Typical High $0.95 | Professional | None | $0.66 | $0.72 | $0.95 |
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 $0.72 Median $1.12 Typical High $1.15 | Facility | None | $0.72 | $1.12 | $1.15 |
Providence Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
United Setting Professional Modifier None Typical Low $0.39 Median $0.50 Typical High $0.65 | Professional | None | $0.39 | $0.50 | $0.65 |
Wellpoint Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
9 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 52 · Reduced service Typical Low $0.33 Median $0.36 Typical High $0.47 | Professional | 52 · Reduced service | $0.33 | $0.36 | $0.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.14 Typical High $0.18 | Professional | 53 · Discontinued | $0.13 | $0.14 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.11 Typical High $0.14 | Professional | 55 · Aftercare only | $0.10 | $0.11 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.09 |
Ambetter Setting Professional Modifier A2 · Dressing, 2 wounds Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | A2 · Dressing, 2 wounds | $77.62 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.33 Median $0.36 Typical High $0.44 | Professional | 52 · Reduced service | $0.33 | $0.36 | $0.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.14 Typical High $0.18 | Professional | 53 · Discontinued | $0.13 | $0.14 | $0.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.11 Typical High $0.13 | Professional | 55 · Aftercare only | $0.10 | $0.11 | $0.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.09 |
Where Texas sits
The same service costs 2.6 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· 29th of 51
$0.65
HI $1.17UT $0.46
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.