How much rates vary
Facilitymedian $138 · 10th to 90th $32 to $229Professionalmedian $26 · 10th to 90th $26 to $115
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 $25.70 Median $35.48 Typical High $56.23 | Facility | None | $25.70 | $35.48 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $26.92 | Professional | None | $25.70 | $26.30 | $26.92 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
BCBS Texas Setting Facility Modifier None Typical Low $69.18 Median $162.18 Typical High $234.42 | Facility | None | $69.18 | $162.18 | $234.42 |
BCBS Texas Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $46.77 Typical High $83.18 | Facility | None | $25.70 | $46.77 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Lucent Health Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Moda Health Setting Facility Modifier None Typical Low $25.70 Median $31.62 Typical High $63.10 | Facility | None | $25.70 | $31.62 | $63.10 |
Moda Health Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $26.92 | Professional | None | $25.70 | $26.30 | $26.92 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $27.54 | Professional | None | $23.99 | $23.99 | $27.54 |
Oscar Health Setting Professional Modifier None Typical Low $28.18 Median $45.71 Typical High $95.50 | Professional | None | $28.18 | $45.71 | $95.50 |
Providence Setting Facility Modifier None Typical Low $25.70 Median $37.15 Typical High $223.87 | Facility | None | $25.70 | $37.15 | $223.87 |
Providence Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
United Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
United Setting Professional Modifier None Typical Low $25.70 Median $27.54 Typical High $29.51 | Professional | None | $25.70 | $27.54 | $29.51 |
Wellpoint Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
14 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 $12.88 Median $18.20 Typical High $28.18 | Facility | 52 · Reduced service | $12.88 | $18.20 | $28.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.13 Median $7.24 Typical High $11.22 | Facility | 53 · Discontinued | $5.13 | $7.24 | $11.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.89 Median $5.37 Typical High $8.51 | Facility | 55 · Aftercare only | $3.89 | $5.37 | $8.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.57 Median $3.63 Typical High $5.62 | Facility | 56 · Pre-op care only | $2.57 | $3.63 | $5.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $12.88 Typical High $13.49 | Professional | 52 · Reduced service | $12.88 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.37 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $3.98 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.69 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $21.88 Median $25.70 Typical High $25.70 | Professional | JW · Drug discarded | $21.88 | $25.70 | $25.70 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | JZ · No drug discarded | $25.70 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $12.88 Typical High $13.18 | Professional | 52 · Reduced service | $12.88 | $12.88 | $13.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.37 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $3.98 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $3.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.63 |
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· 42nd of 51
$25.70
WY $36.31NC $25.12
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.