How much rates vary
Facilitymedian $126 · 10th to 90th $55 to $245Professionalmedian $58 · 10th to 90th $55 to $245
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 $57.54 Median $72.44 Typical High $120.23 | Facility | None | $57.54 | $72.44 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | None | $57.54 | $57.54 | $58.88 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
BCBS Texas Setting Facility Modifier None Typical Low $53.70 Median $131.83 Typical High $245.47 | Facility | None | $53.70 | $131.83 | $245.47 |
BCBS Texas Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Baylor Scott & White Setting Professional Modifier None Typical Low $57.54 Median $60.26 Typical High $61.66 | Professional | None | $57.54 | $60.26 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $109.65 Typical High $181.97 | Facility | None | $57.54 | $109.65 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Lucent Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $134.90 | Facility | None | $54.95 | $66.07 | $134.90 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $57.54 | Professional | None | $54.95 | $54.95 | $57.54 |
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 $58.88 Median $97.72 Typical High $204.17 | Professional | None | $58.88 | $97.72 | $204.17 |
Providence Setting Facility Modifier None Typical Low $57.54 Median $81.28 Typical High $489.78 | Facility | None | $57.54 | $81.28 | $489.78 |
Providence Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $54.95 Median $58.88 Typical High $61.66 | Professional | None | $54.95 | $58.88 | $61.66 |
Wellpoint Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
15 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 $28.84 Median $36.31 Typical High $60.26 | Facility | 52 · Reduced service | $28.84 | $36.31 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $14.45 Typical High $23.99 | Facility | 53 · Discontinued | $11.48 | $14.45 | $23.99 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $10.96 Typical High $18.20 | Facility | 55 · Aftercare only | $8.51 | $10.96 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.24 Typical High $12.02 | Facility | 56 · Pre-op care only | $5.75 | $7.24 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $28.84 Typical High $29.51 | Professional | 52 · Reduced service | $28.84 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.75 | Professional | 53 · Discontinued | $11.48 | $11.48 | $11.75 |
Aetna 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 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $5.89 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $48.98 Median $54.95 Typical High $57.54 | Professional | JZ · No drug discarded | $48.98 | $54.95 | $57.54 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $44.67 Median $95.50 Typical High $154.88 | Facility | JZ · No drug discarded | $44.67 | $95.50 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $27.54 Typical High $28.18 | Professional | 52 · Reduced service | $27.54 | $27.54 | $28.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $11.22 | Professional | 53 · Discontinued | $10.96 | $10.96 | $11.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.51 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.62 |
Moda Health Setting Professional Modifier JZ · No drug discarded Typical Low $56.23 Median $69.18 Typical High $104.71 | Professional | JZ · No drug discarded | $56.23 | $69.18 | $104.71 |
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· 49th of 51
$57.54
AK $70.79NJ $57.54
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.