How much rates vary
Facilitymedian $102 · 10th to 90th $45 to $195Professionalmedian $60 · 10th to 90th $56 to $63
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 $60.26 Median $74.13 Typical High $123.03 | Facility | None | $60.26 | $74.13 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | None | $60.26 | $60.26 | $61.66 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
BCBS Texas Setting Facility Modifier None Typical Low $41.69 Median $104.71 Typical High $194.98 | Facility | None | $41.69 | $104.71 | $194.98 |
BCBS Texas Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Baylor Scott & White Setting Professional Modifier None Typical Low $57.54 Median $60.26 Typical High $79.43 | Professional | None | $57.54 | $60.26 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $114.82 Typical High $190.55 | Facility | None | $60.26 | $114.82 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Lucent Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $102.33 | Professional | None | $54.95 | $54.95 | $102.33 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $67.61 Typical High $117.49 | Facility | None | $56.23 | $67.61 | $117.49 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $60.26 | Professional | None | $56.23 | $56.23 | $60.26 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $63.10 | Professional | None | $54.95 | $54.95 | $63.10 |
Oscar Health Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $208.93 | Professional | None | $60.26 | $100.00 | $208.93 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $87.10 Typical High $512.86 | Facility | None | $56.23 | $87.10 | $512.86 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $63.10 | Professional | None | $56.23 | $60.26 | $63.10 |
Wellpoint Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
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 $30.20 Median $37.15 Typical High $61.66 | Facility | 52 · Reduced service | $30.20 | $37.15 | $61.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $14.79 Typical High $24.55 | Facility | 53 · Discontinued | $12.02 | $14.79 | $24.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.12 Median $10.96 Typical High $18.20 | Facility | 55 · Aftercare only | $9.12 | $10.96 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.41 Typical High $12.30 | Facility | 56 · Pre-op care only | $6.03 | $7.41 | $12.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.20 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.33 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $28.84 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.48 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.75 |
Where Texas sits
Rates are fairly even across states for this service. 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· 43rd of 51
$60.26
AK $74.13OK $58.88
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.