How much rates vary
Facilitymedian $123 · 10th to 90th $69 to $347Professionalmedian $76 · 10th to 90th $56 to $148
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 $58.88 Typical High $91.20 | Facility | None | $54.95 | $58.88 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $104.71 | Professional | None | $57.54 | $77.62 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $91.20 | Professional | None | $58.88 | $69.18 | $91.20 |
BCBS Texas Setting Facility Modifier None Typical Low $100.00 Median $223.87 Typical High $398.11 | Facility | None | $100.00 | $223.87 | $398.11 |
BCBS Texas Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $112.20 | Professional | None | $60.26 | $75.86 | $112.20 |
Baylor Scott & White Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $138.04 | Professional | None | $69.18 | $77.62 | $138.04 |
Christus Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $120.23 | Professional | None | $64.57 | $75.86 | $120.23 |
Health Smart Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $123.03 | Professional | None | $75.86 | $91.20 | $123.03 |
Lucent Health Setting Professional Modifier None Typical Low $91.20 Median $457.09 Typical High $457.09 | Professional | None | $91.20 | $457.09 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $58.88 Typical High $114.82 | Facility | None | $54.95 | $58.88 | $114.82 |
Moda Health Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $109.65 | Professional | None | $57.54 | $77.62 | $109.65 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $54.95 Typical High $74.13 | Professional | None | $10.00 | $54.95 | $74.13 |
Oscar Health Setting Professional Modifier None Typical Low $74.13 Median $131.83 Typical High $162.18 | Professional | None | $74.13 | $131.83 | $162.18 |
Providence Setting Facility Modifier None Typical Low $69.18 Median $95.50 Typical High $134.90 | Facility | None | $69.18 | $95.50 | $134.90 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $128.82 | Professional | None | $64.57 | $75.86 | $128.82 |
United Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $114.82 | Professional | None | $56.23 | $75.86 | $114.82 |
Wellpoint Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
30 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 $28.84 Typical High $29.51 | Facility | 52 · Reduced service | $27.54 | $28.84 | $29.51 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $8.71 | Facility | 55 · Aftercare only | $8.32 | $8.51 | $8.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.75 Typical High $5.89 | Facility | 56 · Pre-op care only | $5.50 | $5.75 | $5.89 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $91.20 Median $95.50 Typical High $95.50 | Facility | AF · Specialist physician | $91.20 | $95.50 | $95.50 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $69.18 Median $70.79 Typical High $70.79 | Facility | HO · Master's level | $69.18 | $70.79 | $70.79 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $77.62 Median $81.28 Typical High $81.28 | Facility | TD · Registered nurse | $77.62 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $28.84 Typical High $34.67 | Professional | 52 · Reduced service | $27.54 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $10.47 | Professional | 55 · Aftercare only | $8.32 | $8.51 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.75 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.50 | $5.75 | $6.92 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $70.79 Median $75.86 Typical High $91.20 | Professional | 24 · Unrelated visit after surgery | $70.79 | $75.86 | $91.20 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $61.66 Median $69.18 Typical High $81.28 | Professional | 25 · Same-day visit | $61.66 | $69.18 | $81.28 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $66.07 Median $69.18 Typical High $70.79 | Professional | 57 · Decision for surgery | $66.07 | $69.18 | $70.79 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $58.88 Median $69.18 Typical High $87.10 | Professional | FS · Shared visit | $58.88 | $69.18 | $87.10 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $69.18 Median $70.79 Typical High $87.10 | Professional | GC · Resident with teaching physician | $69.18 | $70.79 | $87.10 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $67.61 Median $75.86 Typical High $75.86 | Professional | Q6 · Substitute physician, paid per time | $67.61 | $75.86 | $75.86 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | SA · Nurse practitioner | $69.18 | $69.18 | $69.18 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $27.54 Median $28.84 Typical High $29.51 | Facility | 52 · Reduced service | $27.54 | $28.84 | $29.51 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $8.91 | Facility | 55 · Aftercare only | $8.32 | $8.51 | $8.91 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.75 Typical High $5.89 | Facility | 56 · Pre-op care only | $5.50 | $5.75 | $5.89 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $91.20 Median $95.50 Typical High $95.50 | Facility | AF · Specialist physician | $91.20 | $95.50 | $95.50 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $69.18 Median $70.79 Typical High $70.79 | Facility | HO · Master's level | $69.18 | $70.79 | $70.79 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $77.62 Median $81.28 Typical High $81.28 | Facility | TD · Registered nurse | $77.62 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $72.44 Median $114.82 Typical High $251.19 | Professional | 24 · Unrelated visit after surgery | $72.44 | $114.82 | $251.19 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $61.66 Median $100.00 Typical High $269.15 | Professional | 25 · Same-day visit | $61.66 | $100.00 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $28.84 Typical High $33.11 | Professional | 52 · Reduced service | $27.54 | $28.84 | $33.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $10.00 | Professional | 55 · Aftercare only | $8.32 | $8.51 | $10.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.75 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.50 | $5.75 | $6.61 |
Moda Health Setting Professional Modifier 57 · Decision for surgery Typical Low $61.66 Median $85.11 Typical High $251.19 | Professional | 57 · Decision for surgery | $61.66 | $85.11 | $251.19 |
Moda Health Setting Professional Modifier FS · Shared visit Typical Low $63.10 Median $74.13 Typical High $112.20 | Professional | FS · Shared visit | $63.10 | $74.13 | $112.20 |
Moda Health Setting Professional Modifier GC · Resident with teaching physician Typical Low $75.86 Median $87.10 Typical High $181.97 | Professional | GC · Resident with teaching physician | $75.86 | $87.10 | $181.97 |
Where Texas sits
The same service costs 2.4 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· 36th of 51
$75.86
AK $155AL $64.57
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.