How much rates vary
Facilitymedian $170 · 10th to 90th $83 to $331Professionalmedian $85 · 10th to 90th $81 to $363
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 $85.11 Median $114.82 Typical High $177.83 | Facility | None | $85.11 | $114.82 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | None | $85.11 | $85.11 | $89.13 |
BCBS Texas Setting Facility Modifier None Typical Low $81.28 Median $186.21 Typical High $338.84 | Facility | None | $81.28 | $186.21 | $338.84 |
BCBS Texas Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $162.18 Typical High $275.42 | Facility | None | $85.11 | $162.18 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Lucent Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $81.28 Median $102.33 Typical High $199.53 | Facility | None | $81.28 | $102.33 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $85.11 | Professional | None | $81.28 | $81.28 | $85.11 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | None | $81.28 | $81.28 | $93.33 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $173.78 Typical High $302.00 | Professional | None | $89.13 | $173.78 | $302.00 |
Providence Setting Facility Modifier None Typical Low $85.11 Median $123.03 Typical High $741.31 | Facility | None | $85.11 | $123.03 | $741.31 |
Providence Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | None | $81.28 | $87.10 | $93.33 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
11 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 $42.66 Median $53.70 Typical High $89.13 | Facility | 52 · Reduced service | $42.66 | $53.70 | $89.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.98 Median $21.38 Typical High $35.48 | Facility | 53 · Discontinued | $16.98 | $21.38 | $35.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $16.22 Typical High $26.92 | Facility | 55 · Aftercare only | $12.88 | $16.22 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.72 Typical High $16.98 | Facility | 56 · Pre-op care only | $8.32 | $10.72 | $16.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | 52 · Reduced service | $42.66 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $17.78 | Professional | 53 · Discontinued | $16.98 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $13.18 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $8.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | 52 · Reduced service | $40.74 | $40.74 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $16.98 | Professional | 53 · Discontinued | $16.60 | $16.60 | $16.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.59 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.59 |
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· 28th of 51
$85.11
AK $105OK $85.11
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.