How much rates vary
Facilitymedian $219 · 10th to 90th $123 to $631Professionalmedian $107 · 10th to 90th $68 to $229
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 $100.00 Median $107.15 Typical High $138.04 | Facility | None | $100.00 | $107.15 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $144.54 | Professional | None | $100.00 | $117.49 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $131.83 | Professional | None | $87.10 | $87.10 | $131.83 |
BCBS Texas Setting Facility Modifier None Typical Low $177.83 Median $407.38 Typical High $707.95 | Facility | None | $177.83 | $407.38 | $707.95 |
BCBS Texas Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $194.98 | Professional | None | $74.13 | $91.20 | $194.98 |
Christus Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $208.93 | Professional | None | $79.43 | $93.33 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $100.00 Median $107.15 Typical High $199.53 | Facility | None | $100.00 | $107.15 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $144.54 | Professional | None | $102.33 | $117.49 | $144.54 |
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 $93.33 Median $165.96 Typical High $204.17 | Professional | None | $93.33 | $165.96 | $204.17 |
Providence Setting Facility Modifier None Typical Low $104.71 Median $165.96 Typical High $213.80 | Facility | None | $104.71 | $165.96 | $213.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $213.80 | Professional | None | $79.43 | $93.33 | $213.80 |
United Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $213.80 | Professional | None | $102.33 | $134.90 | $213.80 |
Wellpoint Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
20 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 $50.12 Median $52.48 Typical High $53.70 | Facility | 52 · Reduced service | $50.12 | $52.48 | $53.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $15.85 | Facility | 55 · Aftercare only | $15.14 | $15.49 | $15.85 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $10.72 | Facility | 56 · Pre-op care only | $10.00 | $10.47 | $10.72 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $138.04 Median $141.25 Typical High $144.54 | Facility | AF · Specialist physician | $138.04 | $141.25 | $144.54 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $104.71 Median $107.15 Typical High $109.65 | Facility | HO · Master's level | $104.71 | $107.15 | $109.65 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $117.49 Median $120.23 Typical High $123.03 | Facility | TD · Registered nurse | $117.49 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $52.48 Typical High $53.70 | Professional | 52 · Reduced service | $50.12 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $15.85 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.00 | $10.47 | $10.72 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 24 · Unrelated visit after surgery | $87.10 | $87.10 | $87.10 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $87.10 Median $87.10 Typical High $91.20 | Professional | 25 · Same-day visit | $87.10 | $87.10 | $91.20 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $50.12 Median $52.48 Typical High $53.70 | Facility | 52 · Reduced service | $50.12 | $52.48 | $53.70 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $15.85 | Facility | 55 · Aftercare only | $15.14 | $15.49 | $15.85 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $10.72 | Facility | 56 · Pre-op care only | $10.00 | $10.47 | $10.72 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $138.04 Median $141.25 Typical High $144.54 | Facility | AF · Specialist physician | $138.04 | $141.25 | $144.54 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $104.71 Median $107.15 Typical High $109.65 | Facility | HO · Master's level | $104.71 | $107.15 | $109.65 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $117.49 Median $120.23 Typical High $123.03 | Facility | TD · Registered nurse | $117.49 | $120.23 | $123.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $52.48 Typical High $53.70 | Professional | 52 · Reduced service | $50.12 | $52.48 | $53.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $15.85 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $15.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.00 | $10.47 | $10.72 |
Where Texas sits
The same service costs 2.0 times more in Alaska than in Washington, DC. 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· 47th of 51
$107
AK $209DC $102
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.