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 $575.44 Median $575.44 Typical High $616.60 | Facility | None | $575.44 | $575.44 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,148.15 | Professional | None | $575.44 | $575.44 | $1,148.15 |
Ambetter Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
BCBS Texas Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,023.29 | Professional | None | $616.60 | $616.60 | $1,023.29 |
Christus Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $724.44 | Professional | None | $524.81 | $524.81 | $724.44 |
Lucent Health Setting Professional Modifier None Typical Low $6,606.93 Median $9,772.37 Typical High $9,772.37 | Professional | None | $6,606.93 | $9,772.37 | $9,772.37 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $741.31 Typical High $1,318.26 | Facility | None | $371.54 | $741.31 | $1,318.26 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,148.15 | Professional | None | $575.44 | $575.44 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $870.96 Typical High $870.96 | Professional | None | $81.28 | $870.96 | $870.96 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $724.44 Typical High $1,318.26 | Facility | None | $562.34 | $724.44 | $1,318.26 |
Providence Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $724.44 | Professional | None | $524.81 | $524.81 | $724.44 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Facility | None | $1,348.96 | $1,348.96 | $1,584.89 |
United Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $870.96 | Professional | None | $478.63 | $724.44 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $85.11 Median $85.11 Typical High $169.82 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $114.82 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $114.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $169.82 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $114.82 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $114.82 |
Where Texas sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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
$759
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.