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 $2.19 Median $3.02 Typical High $5.25 | Facility | None | $2.19 | $3.02 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.24 Typical High $2.51 | Professional | None | $2.19 | $2.24 | $2.51 |
BCBS Texas Setting Facility Modifier None Typical Low $2.19 Median $4.79 Typical High $9.55 | Facility | None | $2.19 | $4.79 | $9.55 |
BCBS Texas Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Cigna Setting Facility Modifier None Typical Low $2.19 Median $4.17 Typical High $7.08 | Facility | None | $2.19 | $4.17 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Moda Health Setting Facility Modifier None Typical Low $2.45 Median $4.90 Typical High $18.20 | Facility | None | $2.45 | $4.90 | $18.20 |
Moda Health Setting Professional Modifier None Typical Low $2.24 Median $2.40 Typical High $2.63 | Professional | None | $2.24 | $2.40 | $2.63 |
Molina Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Providence Setting Facility Modifier None Typical Low $2.19 Median $3.16 Typical High $18.62 | Facility | None | $2.19 | $3.16 | $18.62 |
Providence Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
Wellpoint Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
6 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 Facility Modifier 55 · Aftercare only Typical Low $0.33 Median $0.56 Typical High $0.78 | Facility | 55 · Aftercare only | $0.33 | $0.56 | $0.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.38 Typical High $0.52 | Facility | 56 · Pre-op care only | $0.22 | $0.38 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.33 Typical High $0.36 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.36 Median $0.36 Typical High $0.37 | Professional | 55 · Aftercare only | $0.36 | $0.36 | $0.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.24 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.24 | $0.24 | $0.25 |
Where Texas sits
The same service costs 1.9 times more in Wyoming than in South Carolina. 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· 3rd of 51
$3.63
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.