How much rates vary
Facilitymedian $117 · 10th to 90th $79 to $417Professionalmedian $107 · 10th to 90th $71 to $174
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 $60.26 Median $75.86 Typical High $120.23 | Facility | None | $60.26 | $75.86 | $120.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $61.66 Median $107.15 Typical High $141.25 | Professional | None (both parts) | $61.66 | $107.15 | $141.25 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $85.11 Median $93.33 Typical High $114.82 | Professional | None (both parts) | $85.11 | $93.33 | $114.82 |
BCBS Texas Setting Facility Modifier None Typical Low $128.82 Median $288.40 Typical High $524.81 | Facility | None | $128.82 | $288.40 | $524.81 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $117.49 Median $169.82 Typical High $234.42 | Professional | None (both parts) | $117.49 | $169.82 | $234.42 |
Baylor Scott & White Setting Professional Modifier None (both parts) Typical Low $100.00 Median $117.49 Typical High $128.82 | Professional | None (both parts) | $100.00 | $117.49 | $128.82 |
Christus Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna 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 Professional Modifier None (both parts) Typical Low $74.13 Median $100.00 Typical High $158.49 | Professional | None (both parts) | $74.13 | $100.00 | $158.49 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None (both parts) | $741.31 | $741.31 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $61.66 Median $91.20 Typical High $141.25 | Facility | None | $61.66 | $91.20 | $141.25 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $61.66 Median $107.15 Typical High $141.25 | Professional | None (both parts) | $61.66 | $107.15 | $141.25 |
Molina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $81.28 Typical High $97.72 | Professional | None (both parts) | $30.20 | $81.28 | $97.72 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $104.71 Median $114.82 Typical High $131.83 | Professional | None (both parts) | $104.71 | $114.82 | $131.83 |
Providence Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $158.49 | Facility | None | $85.11 | $109.65 | $158.49 |
Providence Setting Professional Modifier None (both parts) Typical Low $72.44 Median $97.72 Typical High $158.49 | Professional | None (both parts) | $72.44 | $97.72 | $158.49 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $100.00 | Facility | None | $64.57 | $64.57 | $100.00 |
United Setting Professional Modifier None (both parts) Typical Low $75.86 Median $104.71 Typical High $154.88 | Professional | None (both parts) | $75.86 | $104.71 | $154.88 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None (both parts) | $112.20 | $112.20 | $112.20 |
24 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 $30.20 Median $36.31 Typical High $40.74 | Facility | 52 · Reduced service | $30.20 | $36.31 | $40.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.91 Median $10.72 Typical High $12.02 | Facility | 55 · Aftercare only | $8.91 | $10.72 | $12.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.24 Typical High $8.13 | Facility | 56 · Pre-op care only | $6.03 | $7.24 | $8.13 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $141.25 Median $141.25 Typical High $144.54 | Facility | AF · Specialist physician | $141.25 | $141.25 | $144.54 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | HO · Master's level | $107.15 | $107.15 | $107.15 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | TD · Registered nurse | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $38.02 Typical High $52.48 | Professional | 52 · Reduced service | $30.20 | $38.02 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $11.48 Typical High $15.49 | Professional | 55 · Aftercare only | $8.91 | $11.48 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.59 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.03 | $7.59 | $10.47 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $72.44 Median $109.65 Typical High $120.23 | Professional | 25 · Same-day visit | $72.44 | $109.65 | $120.23 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | Q6 · Substitute physician, paid per time | $109.65 | $109.65 | $109.65 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | SA · Nurse practitioner | $85.11 | $85.11 | $85.11 |
Ambetter Setting Professional Modifier TH · Pregnancy care Typical Low $85.11 Median $109.65 Typical High $109.65 | Professional | TH · Pregnancy care | $85.11 | $109.65 | $109.65 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 26 · Professional part | $112.20 | $112.20 | $112.20 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $30.20 Median $36.31 Typical High $40.74 | Facility | 52 · Reduced service | $30.20 | $36.31 | $40.74 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $8.91 Median $10.96 Typical High $12.02 | Facility | 55 · Aftercare only | $8.91 | $10.96 | $12.02 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.24 Typical High $8.13 | Facility | 56 · Pre-op care only | $6.03 | $7.24 | $8.13 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $141.25 Median $141.25 Typical High $144.54 | Facility | AF · Specialist physician | $141.25 | $141.25 | $144.54 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | HO · Master's level | $107.15 | $107.15 | $107.15 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | TD · Registered nurse | $120.23 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $100.00 Median $398.11 Typical High $467.74 | Professional | 25 · Same-day visit | $100.00 | $398.11 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $38.02 Typical High $46.77 | Professional | 52 · Reduced service | $30.20 | $38.02 | $46.77 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $11.48 Typical High $13.80 | Professional | 55 · Aftercare only | $8.91 | $11.48 | $13.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.59 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.03 | $7.59 | $9.33 |
Where Texas sits
The same service costs 2.5 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· 30th of 51
$107
AK $204AL $83.18
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.