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 $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $67.61 | Professional | None | $33.88 | $33.88 | $67.61 |
BCBS Texas Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Christus Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
Lucent Health Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $562.34 | Professional | None | $389.05 | $562.34 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $21.88 Median $42.66 Typical High $77.62 | Facility | None | $21.88 | $42.66 | $77.62 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $67.61 | Professional | None | $33.88 | $33.88 | $67.61 |
Providence Setting Facility Modifier None Typical Low $33.11 Median $43.65 Typical High $77.62 | Facility | None | $33.11 | $43.65 | $77.62 |
Providence Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $93.33 | Facility | None | $79.43 | $79.43 | $93.33 |
United Setting Professional Modifier None Typical Low $28.18 Median $42.66 Typical High $51.29 | Professional | None | $28.18 | $42.66 | $51.29 |
Wellpoint Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
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 $5.01 Median $5.01 Typical High $10.00 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $6.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $10.00 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $10.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $6.76 |
Where Texas sits
The same service costs 2.2 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· 32nd of 51
$42.66
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.