How much rates vary
Facilitymedian $5,754 · 10th to 90th $2,692 to $10,715Professionalmedian $2,884 · 10th to 90th $2,570 to $12,303
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 $2,884.03 Median $3,715.35 Typical High $6,165.95 | Facility | None | $2,884.03 | $3,715.35 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,951.21 | Professional | None | $2,884.03 | $2,884.03 | $2,951.21 |
Ambetter Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
BCBS Texas Setting Facility Modifier None Typical Low $2,398.83 Median $5,888.44 Typical High $11,220.18 | Facility | None | $2,398.83 | $5,888.44 | $11,220.18 |
BCBS Texas Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $5,370.32 Typical High $9,120.11 | Facility | None | $2,884.03 | $5,370.32 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Lucent Health Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Professional | None | $12,302.69 | $12,302.69 | $12,302.69 |
Moda Health Setting Facility Modifier None Typical Low $2,818.38 Median $3,388.44 Typical High $5,888.44 | Facility | None | $2,818.38 | $3,388.44 | $5,888.44 |
Moda Health Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,884.03 | Professional | None | $2,818.38 | $2,818.38 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,090.30 | Professional | None | $2,691.53 | $2,691.53 | $3,090.30 |
Oscar Health Setting Professional Modifier None Typical Low $3,019.95 Median $6,025.60 Typical High $10,471.29 | Professional | None | $3,019.95 | $6,025.60 | $10,471.29 |
Providence Setting Facility Modifier None Typical Low $2,884.03 Median $4,073.80 Typical High $24,547.09 | Facility | None | $2,884.03 | $4,073.80 | $24,547.09 |
Providence Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $3,162.28 | Professional | None | $2,818.38 | $3,019.95 | $3,162.28 |
Wellpoint Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
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 $1,445.44 Median $1,862.09 Typical High $3,090.30 | Facility | 52 · Reduced service | $1,445.44 | $1,862.09 | $3,090.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $575.44 Median $741.31 Typical High $1,230.27 | Facility | 53 · Discontinued | $575.44 | $741.31 | $1,230.27 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $426.58 Median $549.54 Typical High $912.01 | Facility | 55 · Aftercare only | $426.58 | $549.54 | $912.01 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $288.40 Median $371.54 Typical High $616.60 | Facility | 56 · Pre-op care only | $288.40 | $371.54 | $616.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,445.44 Median $1,445.44 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $588.84 | Professional | 53 · Discontinued | $575.44 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $446.68 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $295.12 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,412.54 Median $1,412.54 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,412.54 | $1,412.54 | $1,445.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 53 · Discontinued | $562.34 | $562.34 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $436.52 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $436.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | 56 · Pre-op care only | $281.84 | $281.84 | $288.40 |
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
$2,884
AK $3,548UT $2,884
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.