How much rates vary
Facilitymedian $162 · 10th to 90th $123 to $525Professionalmedian $141 · 10th to 90th $98 to $214
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 $104.71 Median $134.90 Typical High $177.83 | Facility | None | $104.71 | $134.90 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $186.21 | Professional | None | $109.65 | $138.04 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $181.97 | Professional | None | $97.72 | $147.91 | $181.97 |
BCBS Texas Setting Facility Modifier None Typical Low $141.25 Median $354.81 Typical High $691.83 | Facility | None | $141.25 | $354.81 | $691.83 |
BCBS Texas Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $204.17 | Professional | None | $109.65 | $138.04 | $204.17 |
Baylor Scott & White Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $223.87 | Professional | None | $120.23 | $177.83 | $223.87 |
Christus Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $218.78 | Facility | None | $125.89 | $151.36 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $218.78 | Professional | None | $109.65 | $144.54 | $218.78 |
Health Smart Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $186.21 | Facility | None | $169.82 | $169.82 | $186.21 |
Health Smart Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $275.42 | Professional | None | $154.88 | $194.98 | $275.42 |
Lucent Health Setting Professional Modifier None Typical Low $194.98 Median $1,047.13 Typical High $1,047.13 | Professional | None | $194.98 | $1,047.13 | $1,047.13 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $173.78 Typical High $524.81 | Facility | None | $109.65 | $173.78 | $524.81 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $194.98 | Professional | None | $109.65 | $138.04 | $194.98 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $134.90 Typical High $181.97 | Professional | None | $24.55 | $134.90 | $181.97 |
Oscar Health Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $407.38 | Professional | None | $134.90 | $218.78 | $407.38 |
Providence Setting Facility Modifier None Typical Low $114.82 Median $151.36 Typical High $199.53 | Facility | None | $114.82 | $151.36 | $199.53 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $213.80 | Professional | None | $109.65 | $141.25 | $213.80 |
United Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $131.83 | Facility | None | $69.18 | $69.18 | $131.83 |
United Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $199.53 | Professional | None | $102.33 | $138.04 | $199.53 |
Wellpoint Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
44 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 $52.48 Median $61.66 Typical High $69.18 | Facility | 52 · Reduced service | $52.48 | $61.66 | $69.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $18.62 Typical High $20.89 | Facility | 55 · Aftercare only | $15.85 | $18.62 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.30 Typical High $13.80 | Facility | 56 · Pre-op care only | $10.47 | $12.30 | $13.80 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $169.82 Median $177.83 Typical High $177.83 | Facility | AF · Specialist physician | $169.82 | $177.83 | $177.83 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $125.89 Median $131.83 Typical High $134.90 | Facility | HO · Master's level | $125.89 | $131.83 | $134.90 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $144.54 Median $151.36 Typical High $151.36 | Facility | TD · Registered nurse | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $64.57 Typical High $69.18 | Professional | 52 · Reduced service | $52.48 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.50 Typical High $20.89 | Professional | 55 · Aftercare only | $15.85 | $19.50 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.88 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.47 | $12.88 | $13.80 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $114.82 Median $138.04 Typical High $190.55 | Professional | AF · Specialist physician | $114.82 | $138.04 | $190.55 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $85.11 Median $102.33 Typical High $144.54 | Professional | HO · Master's level | $85.11 | $102.33 | $144.54 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $97.72 Median $117.49 Typical High $162.18 | Professional | TD · Registered nurse | $97.72 | $117.49 | $162.18 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $173.78 Median $173.78 Typical High $181.97 | Professional | 24 · Unrelated visit after surgery | $173.78 | $173.78 | $181.97 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $114.82 Median $169.82 Typical High $204.17 | Professional | 25 · Same-day visit | $114.82 | $169.82 | $204.17 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $114.82 Median $173.78 Typical High $173.78 | Professional | 57 · Decision for surgery | $114.82 | $173.78 | $173.78 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 93 · Audio-only telehealth | $114.82 | $114.82 | $114.82 |
Ambetter Setting Professional Modifier AM · Physician, team member Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | AM · Physician, team member | $173.78 | $173.78 | $199.53 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $114.82 Median $177.83 Typical High $199.53 | Professional | GC · Resident with teaching physician | $114.82 | $177.83 | $199.53 |
Ambetter Setting Professional Modifier GY · Excluded by law Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | GY · Excluded by law | $173.78 | $173.78 | $173.78 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $114.82 Median $158.49 Typical High $181.97 | Professional | Q6 · Substitute physician, paid per time | $114.82 | $158.49 | $181.97 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $165.96 Median $173.78 Typical High $181.97 | Professional | SA · Nurse practitioner | $165.96 | $173.78 | $181.97 |
Ambetter Setting Professional Modifier TH · Pregnancy care Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | TH · Pregnancy care | $144.54 | $144.54 | $144.54 |
Ambetter Setting Professional Modifier U1 · State-defined Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | U1 · State-defined | $147.91 | $147.91 | $147.91 |
Ambetter Setting Professional Modifier U7 · State-defined Typical Low $125.89 Median $173.78 Typical High $173.78 | Professional | U7 · State-defined | $125.89 | $173.78 | $173.78 |
Moda Health Setting Facility Modifier 25 · Same-day visit Typical Low $208.93 Median $457.09 Typical High $933.25 | Facility | 25 · Same-day visit | $208.93 | $457.09 | $933.25 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $52.48 Median $63.10 Typical High $69.18 | Facility | 52 · Reduced service | $52.48 | $63.10 | $69.18 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $19.05 Typical High $20.89 | Facility | 55 · Aftercare only | $15.85 | $19.05 | $20.89 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.59 Typical High $13.80 | Facility | 56 · Pre-op care only | $10.47 | $12.59 | $13.80 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $169.82 Median $177.83 Typical High $177.83 | Facility | AF · Specialist physician | $169.82 | $177.83 | $177.83 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $125.89 Median $131.83 Typical High $134.90 | Facility | HO · Master's level | $125.89 | $131.83 | $134.90 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $144.54 Median $151.36 Typical High $151.36 | Facility | TD · Registered nurse | $144.54 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $91.20 Median $177.83 Typical High $323.59 | Professional | 25 · Same-day visit | $91.20 | $177.83 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $64.57 Typical High $69.18 | Professional | 52 · Reduced service | $52.48 | $64.57 | $69.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.50 Typical High $20.89 | Professional | 55 · Aftercare only | $15.85 | $19.50 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.88 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.47 | $12.88 | $13.80 |
Moda Health Setting Professional Modifier 57 · Decision for surgery Typical Low $112.20 Median $194.98 Typical High $436.52 | Professional | 57 · Decision for surgery | $112.20 | $194.98 | $436.52 |
Moda Health Setting Professional Modifier AF · Specialist physician Typical Low $114.82 Median $138.04 Typical High $186.21 | Professional | AF · Specialist physician | $114.82 | $138.04 | $186.21 |
Moda Health Setting Professional Modifier GC · Resident with teaching physician Typical Low $120.23 Median $257.04 Typical High $457.09 | Professional | GC · Resident with teaching physician | $120.23 | $257.04 | $457.09 |
Moda Health Setting Professional Modifier HO · Master's level Typical Low $85.11 Median $102.33 Typical High $138.04 | Professional | HO · Master's level | $85.11 | $102.33 | $138.04 |
Moda Health Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $125.89 Median $169.82 Typical High $263.03 | Professional | Q6 · Substitute physician, paid per time | $125.89 | $169.82 | $263.03 |
Moda Health Setting Professional Modifier SA · Nurse practitioner Typical Low $131.83 Median $158.49 Typical High $323.59 | Professional | SA · Nurse practitioner | $131.83 | $158.49 | $323.59 |
Moda Health Setting Professional Modifier TD · Registered nurse Typical Low $97.72 Median $117.49 Typical High $158.49 | Professional | TD · Registered nurse | $97.72 | $117.49 | $158.49 |
United Setting Professional Modifier G0 · Stroke telehealth Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | G0 · Stroke telehealth | $338.84 | $338.84 | $338.84 |
United Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | GQ · Store-and-forward telehealth | $338.84 | $338.84 | $338.84 |
Where Texas sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 38th of 51
$141
AK $263AL $115
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.