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 $5.13 Median $8.71 Typical High $19.05 | Facility | None | $5.13 | $8.71 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $13.18 Typical High $21.88 | Professional | None | $5.13 | $13.18 | $21.88 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
BCBS Texas Setting Facility Modifier None Typical Low $12.02 Median $26.92 Typical High $47.86 | Facility | None | $12.02 | $26.92 | $47.86 |
BCBS Texas Setting Professional Modifier None Typical Low $7.24 Median $19.50 Typical High $30.90 | Professional | None | $7.24 | $19.50 | $30.90 |
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 Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Lucent Health Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $208.93 | Professional | None | $147.91 | $208.93 | $208.93 |
Moda Health Setting Facility Modifier None Typical Low $7.59 Median $15.49 Typical High $25.70 | Facility | None | $7.59 | $15.49 | $25.70 |
Moda Health Setting Professional Modifier None Typical Low $5.13 Median $13.18 Typical High $21.88 | Professional | None | $5.13 | $13.18 | $21.88 |
Molina Setting Professional Modifier None Typical Low $4.79 Median $26.30 Typical High $36.31 | Professional | None | $4.79 | $26.30 | $36.31 |
Providence Setting Facility Modifier None Typical Low $7.59 Median $17.78 Typical High $27.54 | Facility | None | $7.59 | $17.78 | $27.54 |
Providence Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
United Setting Professional Modifier None Typical Low $7.24 Median $15.49 Typical High $25.70 | Professional | None | $7.24 | $15.49 | $25.70 |
Wellpoint Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
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 $0.76 Median $2.00 Typical High $3.09 | Professional | 55 · Aftercare only | $0.76 | $2.00 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $1.32 Typical High $2.04 | Professional | 56 · Pre-op care only | $0.51 | $1.32 | $2.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $2.00 Typical High $2.88 | Professional | 55 · Aftercare only | $0.76 | $2.00 | $2.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $1.32 Typical High $1.91 | Professional | 56 · Pre-op care only | $0.51 | $1.32 | $1.91 |
Where Texas sits
The same service costs 3.8 times more in Alaska than in Washington, DC. 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· 17th of 51
$22.39
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.