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 $478.63 Median $478.63 Typical High $501.19 | Facility | None | $478.63 | $478.63 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $870.96 | Professional | None | $478.63 | $501.19 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
BCBS Texas Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $645.65 | Professional | None | $512.86 | $512.86 | $645.65 |
Christus Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $851.14 | Facility | None | $724.44 | $724.44 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | None | $537.03 | $537.03 | $724.44 |
Lucent Health Setting Professional Modifier None Typical Low $5,495.41 Median $7,943.28 Typical High $7,943.28 | Professional | None | $5,495.41 | $7,943.28 | $7,943.28 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $602.56 Typical High $1,096.48 | Facility | None | $309.03 | $602.56 | $1,096.48 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $870.96 | Professional | None | $478.63 | $501.19 | $870.96 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $812.83 Typical High $812.83 | Professional | None | $81.28 | $812.83 | $812.83 |
Providence Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $1,096.48 | Facility | None | $467.74 | $724.44 | $1,096.48 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | None | $537.03 | $537.03 | $724.44 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Facility | None | $1,122.02 | $1,122.02 | $1,318.26 |
United Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $691.83 | Professional | None | $371.54 | $537.03 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $70.79 Median $75.86 Typical High $93.33 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $61.66 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $61.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $60.26 |
Where Texas sits
The same service costs 2.0 times more in Montana than in West Virginia. 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· 33rd of 51
$603
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.