How much rates vary
Facilitymedian $174 · 10th to 90th $117 to $676Professionalmedian $155 · 10th to 90th $107 to $245
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 $95.50 Median $112.20 Typical High $173.78 | Facility | None | $95.50 | $112.20 | $173.78 |
Aetna Setting Professional Modifier None (both parts) Typical Low $100.00 Median $151.36 Typical High $199.53 | Professional | None (both parts) | $100.00 | $151.36 | $199.53 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $117.49 Median $158.49 Typical High $173.78 | Professional | None (both parts) | $117.49 | $158.49 | $173.78 |
BCBS Texas Setting Facility Modifier None Typical Low $204.17 Median $467.74 Typical High $831.76 | Facility | None | $204.17 | $467.74 | $831.76 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $173.78 Median $257.04 Typical High $380.19 | Professional | None (both parts) | $173.78 | $257.04 | $380.19 |
Baylor Scott & White Setting Professional Modifier None (both parts) Typical Low $147.91 Median $154.88 Typical High $181.97 | Professional | None (both parts) | $147.91 | $154.88 | $181.97 |
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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Professional Modifier None (both parts) Typical Low $112.20 Median $144.54 Typical High $239.88 | Professional | None (both parts) | $112.20 | $144.54 | $239.88 |
Health Smart Setting Professional Modifier None (both parts) Typical Low $181.97 Median $204.17 Typical High $724.44 | Professional | None (both parts) | $181.97 | $204.17 | $724.44 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None (both parts) | $1,122.02 | $1,122.02 | $1,122.02 |
Moda Health Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $204.17 | Facility | None | $100.00 | $141.25 | $204.17 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $100.00 Median $151.36 Typical High $199.53 | Professional | None (both parts) | $100.00 | $151.36 | $199.53 |
Molina Setting Professional Modifier None (both parts) Typical Low $95.50 Median $123.03 Typical High $154.88 | Professional | None (both parts) | $95.50 | $123.03 | $154.88 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $138.04 Median $162.18 Typical High $186.21 | Professional | None (both parts) | $138.04 | $162.18 | $186.21 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $158.49 Typical High $234.42 | Facility | None | $131.83 | $158.49 | $234.42 |
Providence Setting Professional Modifier None (both parts) Typical Low $109.65 Median $144.54 Typical High $239.88 | Professional | None (both parts) | $109.65 | $144.54 | $239.88 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None (both parts) Typical Low $120.23 Median $162.18 Typical High $234.42 | Professional | None (both parts) | $120.23 | $162.18 | $234.42 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None (both parts) | $162.18 | $162.18 | $162.18 |
26 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 $47.86 Median $52.48 Typical High $60.26 | Facility | 52 · Reduced service | $47.86 | $52.48 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.45 Median $15.85 Typical High $18.20 | Facility | 55 · Aftercare only | $14.45 | $15.85 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.47 Typical High $12.02 | Facility | 56 · Pre-op care only | $9.55 | $10.47 | $12.02 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $190.55 Median $199.53 Typical High $204.17 | Facility | AF · Specialist physician | $190.55 | $199.53 | $204.17 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $144.54 Median $147.91 Typical High $151.36 | Facility | HO · Master's level | $144.54 | $147.91 | $151.36 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $162.18 Median $169.82 Typical High $173.78 | Facility | TD · Registered nurse | $162.18 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $56.23 Typical High $79.43 | Professional | 52 · Reduced service | $47.86 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.98 Typical High $23.44 | Professional | 55 · Aftercare only | $14.45 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.22 Typical High $15.85 | Professional | 56 · Pre-op care only | $9.55 | $11.22 | $15.85 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $131.83 Median $158.49 Typical High $194.98 | Professional | 25 · Same-day visit | $131.83 | $158.49 | $194.98 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | 57 · Decision for surgery | $131.83 | $131.83 | $158.49 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | FS · Shared visit | $223.87 | $223.87 | $223.87 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | SA · Nurse practitioner | $112.20 | $112.20 | $112.20 |
Ambetter Setting Professional Modifier TH · Pregnancy care Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | TH · Pregnancy care | $131.83 | $131.83 | $131.83 |
Ambetter Setting Professional Modifier U7 · State-defined Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | U7 · State-defined | $131.83 | $131.83 | $131.83 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 26 · Professional part | $165.96 | $165.96 | $165.96 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $47.86 Median $53.70 Typical High $60.26 | Facility | 52 · Reduced service | $47.86 | $53.70 | $60.26 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $14.45 Median $16.22 Typical High $18.20 | Facility | 55 · Aftercare only | $14.45 | $16.22 | $18.20 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.22 Typical High $12.02 | Facility | 56 · Pre-op care only | $9.55 | $11.22 | $12.02 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $190.55 Median $199.53 Typical High $204.17 | Facility | AF · Specialist physician | $190.55 | $199.53 | $204.17 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $144.54 Median $147.91 Typical High $151.36 | Facility | HO · Master's level | $144.54 | $147.91 | $151.36 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $162.18 Median $169.82 Typical High $173.78 | Facility | TD · Registered nurse | $162.18 | $169.82 | $173.78 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $316.23 Median $575.44 Typical High $676.08 | Professional | 25 · Same-day visit | $316.23 | $575.44 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $56.23 Typical High $70.79 | Professional | 52 · Reduced service | $47.86 | $56.23 | $70.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.98 Typical High $20.89 | Professional | 55 · Aftercare only | $14.45 | $16.98 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.22 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.55 | $11.22 | $14.13 |
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· 33rd of 51
$155
AK $288AL $123
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.