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 $2.75 Median $2.75 Typical High $3.02 | Facility | None | $2.75 | $2.75 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $5.50 | Professional | None | $2.75 | $2.75 | $5.50 |
BCBS Texas Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Christus Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Lucent Health Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $46.77 | Professional | None | $32.36 | $46.77 | $46.77 |
Moda Health Setting Facility Modifier None Typical Low $1.82 Median $3.55 Typical High $6.46 | Facility | None | $1.82 | $3.55 | $6.46 |
Moda Health Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $5.50 | Professional | None | $2.75 | $2.75 | $5.50 |
Providence Setting Facility Modifier None Typical Low $2.69 Median $3.55 Typical High $6.46 | Facility | None | $2.69 | $3.55 | $6.46 |
Providence Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
United Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Facility | None | $6.46 | $6.46 | $7.59 |
United Setting Professional Modifier None Typical Low $2.34 Median $3.55 Typical High $4.27 | Professional | None | $2.34 | $3.55 | $4.27 |
Wellpoint Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
8 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 52 · Reduced service Typical Low $1.38 Median $1.38 Typical High $2.75 | Professional | 52 · Reduced service | $1.38 | $1.38 | $2.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.56 Typical High $1.12 | Professional | 53 · Discontinued | $0.56 | $0.56 | $1.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.42 Typical High $0.83 | Professional | 55 · Aftercare only | $0.42 | $0.42 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.38 Median $1.38 Typical High $2.75 | Professional | 52 · Reduced service | $1.38 | $1.38 | $2.75 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.56 Typical High $1.12 | Professional | 53 · Discontinued | $0.56 | $0.56 | $1.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.42 Typical High $0.83 | Professional | 55 · Aftercare only | $0.42 | $0.42 | $0.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.56 |
Where Texas sits
The same service costs 4.9 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· 32nd of 51
$3.55
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.