How much rates vary
Facilitymedian $234 · 10th to 90th $78 to $447Professionalmedian $56 · 10th to 90th $55 to $295
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 $54.95 Median $74.13 Typical High $123.03 | Facility | None | $54.95 | $74.13 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | None | $54.95 | $54.95 | $56.23 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
BCBS Texas Setting Facility Modifier None Typical Low $112.20 Median $275.42 Typical High $457.09 | Facility | None | $112.20 | $275.42 | $457.09 |
BCBS Texas Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $100.00 Typical High $173.78 | Facility | None | $54.95 | $100.00 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Lucent Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $295.12 | Professional | None | $245.47 | $245.47 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $67.61 Typical High $117.49 | Facility | None | $56.23 | $67.61 | $117.49 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $57.54 | Professional | None | $54.95 | $56.23 | $57.54 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $89.13 | Professional | None | $77.62 | $77.62 | $89.13 |
Oscar Health Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $208.93 | Professional | None | $60.26 | $100.00 | $208.93 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $79.43 Typical High $467.74 | Facility | None | $54.95 | $79.43 | $467.74 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
United Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
United Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $63.10 | Professional | None | $56.23 | $58.88 | $63.10 |
Wellpoint Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
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 $27.54 Median $38.90 Typical High $61.66 | Facility | 52 · Reduced service | $27.54 | $38.90 | $61.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.96 Median $15.85 Typical High $24.55 | Facility | 53 · Discontinued | $10.96 | $15.85 | $24.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $11.75 Typical High $18.20 | Facility | 55 · Aftercare only | $8.32 | $11.75 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.76 Typical High $12.30 | Facility | 56 · Pre-op care only | $5.50 | $7.76 | $12.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $27.54 Typical High $28.18 | Professional | 52 · Reduced service | $27.54 | $27.54 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $11.22 | Professional | 53 · Discontinued | $10.96 | $10.96 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.51 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.62 |
Moda Health 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 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.48 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.71 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.71 |
Moda Health 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 |
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· 21st of 51
$56.23
AK $75.86NH $54.95
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.