How much rates vary
Facilitymedian $60 · 10th to 90th $28 to $115Professionalmedian $32 · 10th to 90th $31 to $34
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 $32.36 Median $42.66 Typical High $70.79 | Facility | None | $32.36 | $42.66 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $32.36 Typical High $33.88 | Professional | None | $31.62 | $32.36 | $33.88 |
BCBS Texas Setting Facility Modifier None Typical Low $25.70 Median $63.10 Typical High $117.49 | Facility | None | $25.70 | $63.10 | $117.49 |
BCBS Texas Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $46.77 Typical High $100.00 | Facility | None | $31.62 | $46.77 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Lucent Health Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $53.70 | Professional | None | $40.74 | $40.74 | $53.70 |
Moda Health Setting Facility Modifier None Typical Low $21.88 Median $36.31 Typical High $67.61 | Facility | None | $21.88 | $36.31 | $67.61 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $33.88 | Professional | None | $32.36 | $32.36 | $33.88 |
Molina Setting Professional Modifier None Typical Low $22.91 Median $30.20 Typical High $30.20 | Professional | None | $22.91 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $31.62 Median $44.67 Typical High $269.15 | Facility | None | $31.62 | $44.67 | $269.15 |
Providence Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $34.67 | Professional | None | $30.90 | $32.36 | $34.67 |
Wellpoint Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
16 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 $16.22 Median $21.38 Typical High $35.48 | Facility | 52 · Reduced service | $16.22 | $21.38 | $35.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.46 Median $8.51 Typical High $14.13 | Facility | 53 · Discontinued | $6.46 | $8.51 | $14.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.90 Median $6.46 Typical High $10.72 | Facility | 55 · Aftercare only | $4.90 | $6.46 | $10.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.27 Typical High $7.08 | Facility | 56 · Pre-op care only | $3.24 | $4.27 | $7.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $16.22 Typical High $16.60 | Professional | 52 · Reduced service | $15.85 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.46 Typical High $6.76 | Professional | 53 · Discontinued | $6.31 | $6.46 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.90 Typical High $5.01 | Professional | 55 · Aftercare only | $4.68 | $4.90 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.24 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.16 | $3.24 | $3.39 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $16.22 Median $19.95 Typical High $33.88 | Facility | 52 · Reduced service | $16.22 | $19.95 | $33.88 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $6.46 Median $7.94 Typical High $13.49 | Facility | 53 · Discontinued | $6.46 | $7.94 | $13.49 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $4.90 Median $5.89 Typical High $10.23 | Facility | 55 · Aftercare only | $4.90 | $5.89 | $10.23 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.98 Typical High $6.76 | Facility | 56 · Pre-op care only | $3.24 | $3.98 | $6.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $16.22 Typical High $16.60 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.76 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.01 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.01 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.39 |
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· 19th of 51
$31.62
AK $45.71AZ $30.90
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.