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 $1.05 Median $1.05 Typical High $1.05 | Facility | None | $1.05 | $1.05 | $1.05 |
Aetna Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | None | $1.05 | $1.05 | $1.05 |
BCBS Texas Setting Facility Modifier None Typical Low $109.65 Median $288.40 Typical High $549.54 | Facility | None | $109.65 | $288.40 | $549.54 |
BCBS Texas Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Lucent Health Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Moda Health Setting Facility Modifier None Typical Low $1.05 Median $1.51 Typical High $3.98 | Facility | None | $1.05 | $1.51 | $3.98 |
Moda Health Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | None | $1.05 | $1.05 | $1.05 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $44.67 | Professional | None | $30.20 | $30.20 | $44.67 |
Providence Setting Facility Modifier None Typical Low $1.05 Median $1.05 Typical High $1.51 | Facility | None | $1.05 | $1.05 | $1.51 |
United Setting Professional Modifier None Typical Low $54.95 Median $66.07 Typical High $109.65 | Professional | None | $54.95 | $66.07 | $109.65 |
Wellpoint Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | None | $0.62 | $0.62 | $0.62 |
8 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 $0.52 Median $0.52 Typical High $0.52 | Professional | 52 · Reduced service | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 53 · Discontinued | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 52 · Reduced service | $0.52 | $0.52 | $0.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 53 · Discontinued | $0.21 | $0.21 | $0.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.16 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Where Texas sits
The same service costs 177.8 times more in Texas than in Georgia. 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· 1st of 51
$110
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.