How much rates vary
Facilitymedian $71 · 10th to 90th $42 to $186Professionalmedian $47 · 10th to 90th $31 to $100
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 $29.51 Median $31.62 Typical High $91.20 | Facility | None | $29.51 | $31.62 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $69.18 Typical High $91.20 | Professional | None | $30.90 | $69.18 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $50.12 | Professional | None | $37.15 | $43.65 | $50.12 |
BCBS Texas Setting Facility Modifier None Typical Low $50.12 Median $114.82 Typical High $213.80 | Facility | None | $50.12 | $114.82 | $213.80 |
BCBS Texas Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $70.79 | Professional | None | $37.15 | $46.77 | $70.79 |
Baylor Scott & White Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $70.79 | Professional | None | $43.65 | $47.86 | $70.79 |
Christus Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $67.61 | Professional | None | $39.81 | $43.65 | $67.61 |
Health Smart Setting Professional Modifier None Typical Low $45.71 Median $56.23 Typical High $77.62 | Professional | None | $45.71 | $56.23 | $77.62 |
Lucent Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Moda Health Setting Facility Modifier None Typical Low $29.51 Median $31.62 Typical High $91.20 | Facility | None | $29.51 | $31.62 | $91.20 |
Moda Health Setting Professional Modifier None Typical Low $30.90 Median $69.18 Typical High $91.20 | Professional | None | $30.90 | $69.18 | $91.20 |
Molina Setting Professional Modifier None Typical Low $5.01 Median $28.18 Typical High $37.15 | Professional | None | $5.01 | $28.18 | $37.15 |
Oscar Health Setting Professional Modifier None Typical Low $45.71 Median $83.18 Typical High $102.33 | Professional | None | $45.71 | $83.18 | $102.33 |
Providence Setting Facility Modifier None Typical Low $39.81 Median $91.20 Typical High $131.83 | Facility | None | $39.81 | $91.20 | $131.83 |
Providence Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $72.44 | Professional | None | $39.81 | $43.65 | $72.44 |
United Setting Professional Modifier None Typical Low $31.62 Median $41.69 Typical High $64.57 | Professional | None | $31.62 | $41.69 | $64.57 |
Wellpoint Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
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 $14.79 Median $15.49 Typical High $15.85 | Facility | 52 · Reduced service | $14.79 | $15.49 | $15.85 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $4.79 | Facility | 55 · Aftercare only | $4.47 | $4.57 | $4.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.09 Typical High $3.16 | Facility | 56 · Pre-op care only | $2.95 | $3.09 | $3.16 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $91.20 Median $91.20 Typical High $95.50 | Facility | AF · Specialist physician | $91.20 | $91.20 | $95.50 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $69.18 Median $69.18 Typical High $70.79 | Facility | HO · Master's level | $69.18 | $69.18 | $70.79 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $77.62 Median $77.62 Typical High $81.28 | Facility | TD · Registered nurse | $77.62 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $15.49 Typical High $20.89 | Professional | 52 · Reduced service | $14.79 | $15.49 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $6.17 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.09 Typical High $4.17 | Professional | 56 · Pre-op care only | $2.95 | $3.09 | $4.17 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $45.71 Median $45.71 Typical High $102.33 | Professional | 24 · Unrelated visit after surgery | $45.71 | $45.71 | $102.33 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 25 · Same-day visit | $43.65 | $43.65 | $43.65 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | 57 · Decision for surgery | $43.65 | $43.65 | $45.71 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $37.15 Median $52.48 Typical High $56.23 | Professional | FS · Shared visit | $37.15 | $52.48 | $56.23 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $38.02 Median $43.65 Typical High $53.70 | Professional | GC · Resident with teaching physician | $38.02 | $43.65 | $53.70 |
Ambetter Setting Professional Modifier GW · Unrelated to hospice condition Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | GW · Unrelated to hospice condition | $43.65 | $43.65 | $43.65 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $14.79 Median $15.49 Typical High $15.85 | Facility | 52 · Reduced service | $14.79 | $15.49 | $15.85 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $4.79 | Facility | 55 · Aftercare only | $4.47 | $4.57 | $4.79 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.09 Typical High $3.16 | Facility | 56 · Pre-op care only | $2.95 | $3.09 | $3.16 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $91.20 Median $91.20 Typical High $95.50 | Facility | AF · Specialist physician | $91.20 | $91.20 | $95.50 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $69.18 Median $69.18 Typical High $70.79 | Facility | HO · Master's level | $69.18 | $69.18 | $70.79 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $77.62 Median $77.62 Typical High $81.28 | Facility | TD · Registered nurse | $77.62 | $77.62 | $81.28 |
Moda Health Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $53.70 Median $61.66 Typical High $128.82 | Professional | 24 · Unrelated visit after surgery | $53.70 | $61.66 | $128.82 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $40.74 Median $85.11 Typical High $144.54 | Professional | 25 · Same-day visit | $40.74 | $85.11 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $15.49 Typical High $19.05 | Professional | 52 · Reduced service | $14.79 | $15.49 | $19.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $5.75 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $5.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.09 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.95 | $3.09 | $3.80 |
Moda Health Setting Professional Modifier GC · Resident with teaching physician Typical Low $47.86 Median $52.48 Typical High $95.50 | Professional | GC · Resident with teaching physician | $47.86 | $52.48 | $95.50 |
Where Texas sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 32nd of 51
$47.86
AK $100NJ $37.15
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.