How much rates vary
Facilitymedian $191 · 10th to 90th $72 to $363Professionalmedian $60 · 10th to 90th $59 to $316
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 $58.88 Median $79.43 Typical High $131.83 | Facility | None | $58.88 | $79.43 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $60.26 | Professional | None | $58.88 | $58.88 | $60.26 |
BCBS Texas Setting Facility Modifier None Typical Low $89.13 Median $213.80 Typical High $380.19 | Facility | None | $89.13 | $213.80 | $380.19 |
BCBS Texas Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $109.65 Typical High $186.21 | Facility | None | $58.88 | $109.65 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Lucent Health Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $72.44 Typical High $125.89 | Facility | None | $60.26 | $72.44 | $125.89 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | None | $60.26 | $60.26 | $61.66 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | None | $63.10 | $63.10 | $72.44 |
Oscar Health Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $218.78 | Professional | None | $64.57 | $109.65 | $218.78 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $83.18 Typical High $501.19 | Facility | None | $58.88 | $83.18 | $501.19 |
Providence Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $67.61 | Professional | None | $60.26 | $63.10 | $67.61 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
13 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 $28.84 Median $38.90 Typical High $66.07 | Facility | 52 · Reduced service | $28.84 | $38.90 | $66.07 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.75 Median $15.85 Typical High $26.30 | Facility | 53 · Discontinued | $11.75 | $15.85 | $26.30 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.71 Median $11.75 Typical High $19.50 | Facility | 55 · Aftercare only | $8.71 | $11.75 | $19.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.94 Typical High $13.18 | Facility | 56 · Pre-op care only | $5.89 | $7.94 | $13.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $28.84 Typical High $30.20 | Professional | 52 · Reduced service | $28.84 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $12.02 | Professional | 53 · Discontinued | $11.75 | $11.75 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $8.91 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $6.03 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $60.26 Median $60.26 Typical High $63.10 | Professional | JZ · No drug discarded | $60.26 | $60.26 | $63.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.20 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $9.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.17 |
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· 30th of 51
$60.26
AK $79.43GA $58.88
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.