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 $3.16 Median $3.24 Typical High $3.55 | Facility | None | $3.16 | $3.24 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.31 Typical High $4.07 | Professional | None | $3.02 | $3.31 | $4.07 |
BCBS Texas Setting Facility Modifier None Typical Low $3.89 Median $5.75 Typical High $14.13 | Facility | None | $3.89 | $5.75 | $14.13 |
BCBS Texas Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Christus Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.72 | Facility | None | $3.02 | $3.02 | $3.72 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
Lucent Health Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $38.02 | Professional | None | $25.12 | $38.02 | $38.02 |
Moda Health Setting Facility Modifier None Typical Low $1.38 Median $3.24 Typical High $5.13 | Facility | None | $1.38 | $3.24 | $5.13 |
Moda Health Setting Professional Modifier None Typical Low $3.02 Median $3.31 Typical High $4.37 | Professional | None | $3.02 | $3.31 | $4.37 |
Molina Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Providence Setting Facility Modifier None Typical Low $2.14 Median $3.02 Typical High $5.13 | Facility | None | $2.14 | $3.02 | $5.13 |
Providence Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
United Setting Professional Modifier None Typical Low $1.51 Median $2.29 Typical High $3.02 | Professional | None | $1.51 | $2.29 | $3.02 |
Wellpoint Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
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 $0.45 Median $0.49 Typical High $0.65 | Professional | 55 · Aftercare only | $0.45 | $0.49 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.33 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.30 | $0.33 | $0.41 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.49 Typical High $0.62 | Professional | 55 · Aftercare only | $0.45 | $0.49 | $0.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.33 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.30 | $0.33 | $0.41 |
Where Texas sits
The same service costs 2.2 times more in Kansas than in Delaware. 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· 22nd of 51
$3.24
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.