How much rates vary
Facilitymedian $245 · 10th to 90th $85 to $479Professionalmedian $68 · 10th to 90th $68 to $74
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 $107.15 Typical High $147.91 | Facility | None | $67.61 | $107.15 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $74.13 | Professional | None | $67.61 | $67.61 | $74.13 |
BCBS Texas Setting Facility Modifier None Typical Low $112.20 Median $295.12 Typical High $478.63 | Facility | None | $112.20 | $295.12 | $478.63 |
BCBS Texas Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $125.89 Typical High $213.80 | Facility | None | $67.61 | $125.89 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $89.13 Typical High $165.96 | Facility | None | $67.61 | $89.13 | $165.96 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $74.13 | Professional | None | $67.61 | $69.18 | $74.13 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $74.13 Typical High $74.13 | Professional | None | $46.77 | $74.13 | $74.13 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $95.50 Typical High $575.44 | Facility | None | $67.61 | $95.50 | $575.44 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Wellpoint Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
12 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 Facility Modifier 52 · Reduced service Typical Low $33.11 Median $53.70 Typical High $74.13 | Facility | 52 · Reduced service | $33.11 | $53.70 | $74.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.49 Median $21.88 Typical High $29.51 | Facility | 53 · Discontinued | $13.49 | $21.88 | $29.51 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.00 Median $16.22 Typical High $22.39 | Facility | 55 · Aftercare only | $10.00 | $16.22 | $22.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.72 Typical High $14.79 | Facility | 56 · Pre-op care only | $6.76 | $10.72 | $14.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $33.88 Typical High $37.15 | Professional | 52 · Reduced service | $33.11 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $14.79 | Professional | 53 · Discontinued | $13.49 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $10.96 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.41 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $33.88 Typical High $35.48 | Professional | 52 · Reduced service | $33.88 | $33.88 | $35.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.80 Typical High $14.13 | Professional | 53 · Discontinued | $13.49 | $13.80 | $14.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.47 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.92 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.76 | $6.92 | $7.08 |
Where Texas sits
The same service costs 2.0 times more in Oklahoma than in New Mexico. 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· 2nd of 51
$129
OK $135NM $67.61
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.