How much rates vary
Facilitymedian $110 · 10th to 90th $54 to $209Professionalmedian $56 · 10th to 90th $54 to $240
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 $53.70 Median $64.57 Typical High $117.49 | Facility | None | $53.70 | $64.57 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $57.54 | Professional | None | $56.23 | $56.23 | $57.54 |
BCBS Texas Setting Facility Modifier None Typical Low $44.67 Median $112.20 Typical High $208.93 | Facility | None | $44.67 | $112.20 | $208.93 |
BCBS Texas Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $109.65 Typical High $181.97 | Facility | None | $56.23 | $109.65 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Lucent Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $58.88 Typical High $93.33 | Facility | None | $53.70 | $58.88 | $93.33 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $54.95 | Professional | None | $53.70 | $53.70 | $54.95 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $83.18 | Professional | None | $40.74 | $53.70 | $83.18 |
Oscar Health Setting Professional Modifier None Typical Low $57.54 Median $95.50 Typical High $194.98 | Professional | None | $57.54 | $95.50 | $194.98 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $81.28 Typical High $478.63 | Facility | None | $56.23 | $81.28 | $478.63 |
Providence Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $60.26 | Professional | None | $53.70 | $56.23 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
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 $26.92 Median $31.62 Typical High $57.54 | Facility | 52 · Reduced service | $26.92 | $31.62 | $57.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.72 Median $12.88 Typical High $23.44 | Facility | 53 · Discontinued | $10.72 | $12.88 | $23.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.13 Median $9.55 Typical High $17.38 | Facility | 55 · Aftercare only | $8.13 | $9.55 | $17.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.46 Typical High $11.75 | Facility | 56 · Pre-op care only | $5.37 | $6.46 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $28.84 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.75 | Professional | 53 · Discontinued | $11.22 | $11.22 | $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 $5.62 Median $5.62 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $26.92 Typical High $27.54 | Professional | 52 · Reduced service | $26.92 | $26.92 | $27.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.96 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $8.32 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $8.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.50 |
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· 45th of 51
$56.23
AK $69.18AL $56.23
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.