How much rates vary
Facilitymedian $44 · 10th to 90th $17 to $10,000Professionalmedian $17 · 10th to 90th $16 to $4,898
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 $17.38 Median $21.38 Typical High $37.15 | Facility | None | $17.38 | $21.38 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.78 | Professional | None | $17.38 | $17.38 | $17.78 |
Ambetter Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
BCBS Setting Facility Modifier None Typical Low $13.49 Median $33.11 Typical High $61.66 | Facility | None | $13.49 | $33.11 | $61.66 |
BCBS Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Christus Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $17.38 Median $32.36 Typical High $54.95 | Facility | None | $17.38 | $32.36 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Lucent Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Moda Health Setting Facility Modifier None Typical Low $16.98 Median $20.42 Typical High $35.48 | Facility | None | $16.98 | $20.42 | $35.48 |
Moda Health Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $17.38 | Professional | None | $16.98 | $16.98 | $17.38 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $19.50 | Professional | None | $16.98 | $16.98 | $19.50 |
Oscar Health Setting Professional Modifier None Typical Low $18.62 Median $36.31 Typical High $63.10 | Professional | None | $18.62 | $36.31 | $63.10 |
Providence Setting Facility Modifier None Typical Low $16.98 Median $24.55 Typical High $147.91 | Facility | None | $16.98 | $24.55 | $147.91 |
Providence Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
United Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
United Setting Professional Modifier None Typical Low $16.98 Median $18.20 Typical High $19.05 | Professional | None | $16.98 | $18.20 | $19.05 |
Wellpoint Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
14 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 $8.51 Median $11.22 Typical High $18.62 | Facility | 52 · Reduced service | $8.51 | $11.22 | $18.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.47 Median $4.47 Typical High $7.41 | Facility | 53 · Discontinued | $3.47 | $4.47 | $7.41 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.57 Median $3.39 Typical High $5.62 | Facility | 55 · Aftercare only | $2.57 | $3.39 | $5.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.74 Median $2.24 Typical High $3.72 | Facility | 56 · Pre-op care only | $1.74 | $2.24 | $3.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.51 Median $8.51 Typical High $8.91 | Professional | 52 · Reduced service | $8.51 | $8.51 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $3.55 | Professional | 53 · Discontinued | $3.47 | $3.47 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $2.63 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $1.78 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $17.38 Median $17.38 Typical High $19.05 | Professional | JZ · No drug discarded | $17.38 | $17.38 | $19.05 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $8.32 Median $35.48 Typical High $40.74 | Facility | JZ · No drug discarded | $8.32 | $35.48 | $40.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 52 · Reduced service | $8.51 | $8.51 | $8.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $3.55 | Professional | 53 · Discontinued | $3.39 | $3.39 | $3.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $2.63 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $2.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.70 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.70 | $1.70 | $1.74 |
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· 33rd of 51
$17.38
AK $21.88NC $16.98
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.