How much rates vary
Facilitymedian $170 · 10th to 90th $76 to $479Professionalmedian $89 · 10th to 90th $63 to $182
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 $77.62 Median $83.18 Typical High $144.54 | Facility | None | $77.62 | $83.18 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $147.91 | Professional | None | $79.43 | $112.20 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $95.50 | Professional | None | $61.66 | $72.44 | $95.50 |
BCBS Texas Setting Facility Modifier None Typical Low $134.90 Median $309.03 Typical High $549.54 | Facility | None | $134.90 | $309.03 | $549.54 |
BCBS Texas Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $154.88 | Professional | None | $63.10 | $77.62 | $154.88 |
Baylor Scott & White Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $245.47 | Professional | None | $74.13 | $89.13 | $245.47 |
Christus Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $158.49 | Professional | None | $67.61 | $79.43 | $158.49 |
Health Smart Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $131.83 | Professional | None | $85.11 | $112.20 | $131.83 |
Lucent Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Moda Health Setting Facility Modifier None Typical Low $77.62 Median $83.18 Typical High $186.21 | Facility | None | $77.62 | $83.18 | $186.21 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $147.91 | Professional | None | $79.43 | $112.20 | $147.91 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $56.23 Typical High $74.13 | Professional | None | $10.00 | $56.23 | $74.13 |
Oscar Health Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $177.83 | Professional | None | $79.43 | $141.25 | $177.83 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $144.54 Typical High $204.17 | Facility | None | $87.10 | $144.54 | $204.17 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $158.49 | Professional | None | $67.61 | $79.43 | $158.49 |
United Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $162.18 | Professional | None | $77.62 | $102.33 | $162.18 |
Wellpoint Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
27 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 $38.90 Median $39.81 Typical High $40.74 | Facility | 52 · Reduced service | $38.90 | $39.81 | $40.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $12.30 | Facility | 55 · Aftercare only | $11.48 | $12.02 | $12.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $8.32 | Facility | 56 · Pre-op care only | $7.76 | $7.94 | $8.32 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $144.54 Median $144.54 Typical High $147.91 | Facility | AF · Specialist physician | $144.54 | $144.54 | $147.91 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $107.15 Median $107.15 Typical High $112.20 | Facility | HO · Master's level | $107.15 | $107.15 | $112.20 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $123.03 Median $123.03 Typical High $125.89 | Facility | TD · Registered nurse | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $39.81 Typical High $40.74 | Professional | 52 · Reduced service | $38.90 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $12.30 | Professional | 55 · Aftercare only | $11.48 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.76 | $7.94 | $8.32 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 24 · Unrelated visit after surgery | $72.44 | $72.44 | $72.44 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | 25 · Same-day visit | $72.44 | $72.44 | $77.62 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | 57 · Decision for surgery | $61.66 | $72.44 | $72.44 |
Ambetter Setting Professional Modifier 99 · Multiple modifiers Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 99 · Multiple modifiers | $72.44 | $72.44 | $72.44 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | FS · Shared visit | $95.50 | $100.00 | $100.00 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $72.44 Median $87.10 Typical High $95.50 | Professional | GC · Resident with teaching physician | $72.44 | $87.10 | $95.50 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $72.44 Median $100.00 Typical High $100.00 | Professional | Q6 · Substitute physician, paid per time | $72.44 | $100.00 | $100.00 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $38.90 Median $39.81 Typical High $40.74 | Facility | 52 · Reduced service | $38.90 | $39.81 | $40.74 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $12.30 | Facility | 55 · Aftercare only | $11.48 | $12.02 | $12.30 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $8.32 | Facility | 56 · Pre-op care only | $7.76 | $7.94 | $8.32 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $144.54 Median $144.54 Typical High $147.91 | Facility | AF · Specialist physician | $144.54 | $144.54 | $147.91 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $107.15 Median $107.15 Typical High $112.20 | Facility | HO · Master's level | $107.15 | $107.15 | $112.20 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $123.03 Median $123.03 Typical High $125.89 | Facility | TD · Registered nurse | $123.03 | $123.03 | $125.89 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $79.43 Median $131.83 Typical High $331.13 | Professional | 25 · Same-day visit | $79.43 | $131.83 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $39.81 Typical High $40.74 | Professional | 52 · Reduced service | $38.90 | $39.81 | $40.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $12.30 | Professional | 55 · Aftercare only | $11.48 | $12.02 | $12.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.76 | $7.94 | $8.32 |
Moda Health Setting Professional Modifier 57 · Decision for surgery Typical Low $72.44 Median $125.89 Typical High $323.59 | Professional | 57 · Decision for surgery | $72.44 | $125.89 | $323.59 |
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
$93.33
AK $174AL $74.13
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.