How much rates vary
Facilitymedian $537 · 10th to 90th $224 to $1,047Professionalmedian $229 · 10th to 90th $214 to $977
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 $223.87 Median $263.03 Typical High $478.63 | Facility | None | $223.87 | $263.03 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $234.42 | Professional | None | $229.09 | $229.09 | $234.42 |
BCBS Texas Setting Facility Modifier None Typical Low $229.09 Median $562.34 Typical High $1,047.13 | Facility | None | $229.09 | $562.34 | $1,047.13 |
BCBS Texas Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $436.52 Typical High $724.44 | Facility | None | $229.09 | $436.52 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Lucent Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $245.47 Typical High $371.54 | Facility | None | $223.87 | $245.47 | $371.54 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $229.09 | Professional | None | $223.87 | $223.87 | $229.09 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $346.74 | Professional | None | $173.78 | $229.09 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $812.83 | Professional | None | $239.88 | $389.05 | $812.83 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $323.59 Typical High $1,949.84 | Facility | None | $229.09 | $323.59 | $1,949.84 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $251.19 | Professional | None | $223.87 | $234.42 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $112.20 Median $131.83 Typical High $239.88 | Facility | 52 · Reduced service | $112.20 | $131.83 | $239.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $44.67 Median $53.70 Typical High $97.72 | Facility | 53 · Discontinued | $44.67 | $53.70 | $97.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.88 Median $39.81 Typical High $72.44 | Facility | 55 · Aftercare only | $33.88 | $39.81 | $72.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.30 Typical High $47.86 | Facility | 56 · Pre-op care only | $22.39 | $26.30 | $47.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $112.20 Typical High $117.49 | Professional | 52 · Reduced service | $112.20 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $46.77 | Professional | 53 · Discontinued | $45.71 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $34.67 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $23.44 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $23.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $109.65 Typical High $114.82 | Professional | 52 · Reduced service | $109.65 | $109.65 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $45.71 | Professional | 53 · Discontinued | $44.67 | $44.67 | $45.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $33.88 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.91 |
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
$229
AK $275VA $229
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.