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 $67.61 Median $67.61 Typical High $74.13 | Facility | None | $67.61 | $67.61 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $134.90 | Professional | None | $67.61 | $67.61 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | None | $112.20 | $120.23 | $120.23 |
BCBS Texas Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $93.33 | Professional | None | $74.13 | $74.13 | $93.33 |
Christus Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Lucent Health Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,148.15 | Professional | None | $794.33 | $1,148.15 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $44.67 Median $87.10 Typical High $158.49 | Facility | None | $44.67 | $87.10 | $158.49 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $134.90 | Professional | None | $67.61 | $67.61 | $134.90 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $81.28 | Professional | None | $77.62 | $77.62 | $81.28 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $158.49 | Facility | None | $66.07 | $100.00 | $158.49 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $186.21 | Facility | None | $158.49 | $158.49 | $186.21 |
United Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $104.71 | Professional | None | $57.54 | $87.10 | $104.71 |
Wellpoint Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $10.23 Median $10.23 Typical High $20.42 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $13.49 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $13.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $20.42 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $13.49 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $13.49 |
Where Texas sits
The same service costs 2.2 times more in Montana than in Florida. 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· 36th of 51
$93.33
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.