How much rates vary
Facilitymedian $79 · 10th to 90th $37 to $151Professionalmedian $44 · 10th to 90th $40 to $47
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 $42.66 Median $52.48 Typical High $91.20 | Facility | None | $42.66 | $52.48 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $44.67 | Professional | None | $43.65 | $43.65 | $44.67 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
BCBS Texas Setting Facility Modifier None Typical Low $33.11 Median $81.28 Typical High $154.88 | Facility | None | $33.11 | $81.28 | $154.88 |
BCBS Texas Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $83.18 Typical High $138.04 | Facility | None | $43.65 | $83.18 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Lucent Health Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $77.62 | Professional | None | $45.71 | $45.71 | $77.62 |
Moda Health Setting Facility Modifier None Typical Low $42.66 Median $51.29 Typical High $87.10 | Facility | None | $42.66 | $51.29 | $87.10 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $43.65 | Professional | None | $42.66 | $42.66 | $43.65 |
Molina Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $47.86 | Professional | None | $41.69 | $41.69 | $47.86 |
Oscar Health Setting Professional Modifier None Typical Low $45.71 Median $74.13 Typical High $154.88 | Professional | None | $45.71 | $74.13 | $154.88 |
Providence Setting Facility Modifier None Typical Low $42.66 Median $63.10 Typical High $371.54 | Facility | None | $42.66 | $63.10 | $371.54 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $47.86 | Professional | None | $42.66 | $44.67 | $47.86 |
Wellpoint Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
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 $21.88 Median $27.54 Typical High $45.71 | Facility | 52 · Reduced service | $21.88 | $27.54 | $45.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.71 Median $10.96 Typical High $18.62 | Facility | 53 · Discontinued | $8.71 | $10.96 | $18.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.61 Median $8.32 Typical High $13.80 | Facility | 55 · Aftercare only | $6.61 | $8.32 | $13.80 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.50 Typical High $9.12 | Facility | 56 · Pre-op care only | $4.37 | $5.50 | $9.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $21.88 Typical High $22.39 | Professional | 52 · Reduced service | $21.88 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.91 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.76 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $20.89 Typical High $21.88 | Professional | 52 · Reduced service | $20.89 | $20.89 | $21.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.46 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.46 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.37 |
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· 17th of 51
$43.65
AK $54.95OR $43.65
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.