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 $66.07 Median $66.07 Typical High $72.44 | Facility | None | $66.07 | $66.07 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $131.83 | Professional | None | $66.07 | $66.07 | $131.83 |
BCBS Texas Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $91.20 | Professional | None | $72.44 | $91.20 | $91.20 |
Christus Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | None | $72.44 | $72.44 | $97.72 |
Lucent Health Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,122.02 | Professional | None | $776.25 | $1,122.02 | $1,122.02 |
Moda Health Setting Facility Modifier None Typical Low $43.65 Median $85.11 Typical High $154.88 | Facility | None | $43.65 | $85.11 | $154.88 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $131.83 | Professional | None | $66.07 | $66.07 | $131.83 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $114.82 | Professional | None | $81.28 | $114.82 | $114.82 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $97.72 Typical High $154.88 | Facility | None | $66.07 | $97.72 | $154.88 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | None | $72.44 | $72.44 | $97.72 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $181.97 | Facility | None | $154.88 | $154.88 | $181.97 |
United Setting Professional Modifier None Typical Low $56.23 Median $85.11 Typical High $102.33 | Professional | None | $56.23 | $85.11 | $102.33 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $10.00 Median $10.00 Typical High $19.95 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $13.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $19.95 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $13.18 |
Where Texas sits
The same service costs 4.2 times more in Kansas 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· 34th of 51
$91.20
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.