How much rates vary
Facilitymedian $794 · 10th to 90th $331 to $1,585Professionalmedian $331 · 10th to 90th $324 to $1,445
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 $331.13 Median $457.09 Typical High $707.95 | Facility | None | $331.13 | $457.09 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $338.84 | Professional | None | $331.13 | $331.13 | $338.84 |
BCBS Texas Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $1,584.89 | Facility | None | $338.84 | $851.14 | $1,584.89 |
BCBS Texas Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $645.65 Typical High $1,047.13 | Facility | None | $331.13 | $645.65 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $389.05 Typical High $676.08 | Facility | None | $323.59 | $389.05 | $676.08 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $331.13 | Professional | None | $323.59 | $323.59 | $331.13 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $363.08 | Professional | None | $316.23 | $316.23 | $363.08 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $575.44 Typical High $1,202.26 | Professional | None | $346.74 | $575.44 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $2,818.38 | Facility | None | $331.13 | $467.74 | $2,818.38 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $363.08 | Professional | None | $323.59 | $338.84 | $363.08 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $165.96 Median $213.80 Typical High $354.81 | Facility | 52 · Reduced service | $165.96 | $213.80 | $354.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $85.11 Typical High $141.25 | Facility | 53 · Discontinued | $66.07 | $85.11 | $141.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $48.98 Median $63.10 Typical High $104.71 | Facility | 55 · Aftercare only | $48.98 | $63.10 | $104.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.11 Median $42.66 Typical High $70.79 | Facility | 56 · Pre-op care only | $33.11 | $42.66 | $70.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $165.96 Typical High $169.82 | Professional | 52 · Reduced service | $165.96 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $67.61 | Professional | 53 · Discontinued | $66.07 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $51.29 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 52 · Reduced service | $162.18 | $162.18 | $165.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $66.07 | Professional | 53 · Discontinued | $64.57 | $64.57 | $66.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $33.11 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $33.11 |
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· 42nd of 51
$331
AK $407VT $331
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.