How much rates vary
Facilitymedian $251 · 10th to 90th $145 to $832Professionalmedian $200 · 10th to 90th $138 to $302
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 $117.49 Median $138.04 Typical High $208.93 | Facility | None | $117.49 | $138.04 | $208.93 |
Aetna Setting Professional Modifier None (both parts) Typical Low $123.03 Median $186.21 Typical High $245.47 | Professional | None (both parts) | $123.03 | $186.21 | $245.47 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $173.78 Median $204.17 Typical High $239.88 | Professional | None (both parts) | $173.78 | $204.17 | $239.88 |
BCBS Texas Setting Facility Modifier None Typical Low $257.04 Median $575.44 Typical High $1,047.13 | Facility | None | $257.04 | $575.44 | $1,047.13 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $218.78 Median $309.03 Typical High $467.74 | Professional | None (both parts) | $218.78 | $309.03 | $467.74 |
Baylor Scott & White Setting Professional Modifier None (both parts) Typical Low $213.80 Median $213.80 Typical High $239.88 | Professional | None (both parts) | $213.80 | $213.80 | $239.88 |
Christus Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Professional Modifier None (both parts) Typical Low $151.36 Median $186.21 Typical High $295.12 | Professional | None (both parts) | $151.36 | $186.21 | $295.12 |
Health Smart Setting Professional Modifier None (both parts) Typical Low $229.09 Median $245.47 Typical High $870.96 | Professional | None (both parts) | $229.09 | $245.47 | $870.96 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None (both parts) | $1,348.96 | $1,348.96 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $181.97 Typical High $245.47 | Facility | None | $123.03 | $181.97 | $245.47 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $123.03 Median $186.21 Typical High $245.47 | Professional | None (both parts) | $123.03 | $186.21 | $245.47 |
Molina Setting Professional Modifier None (both parts) Typical Low $125.89 Median $165.96 Typical High $199.53 | Professional | None (both parts) | $125.89 | $165.96 | $199.53 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $181.97 Median $213.80 Typical High $245.47 | Professional | None (both parts) | $181.97 | $213.80 | $245.47 |
Providence Setting Facility Modifier None Typical Low $173.78 Median $204.17 Typical High $288.40 | Facility | None | $173.78 | $204.17 | $288.40 |
Providence Setting Professional Modifier None (both parts) Typical Low $144.54 Median $186.21 Typical High $295.12 | Professional | None (both parts) | $144.54 | $186.21 | $295.12 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None (both parts) Typical Low $147.91 Median $204.17 Typical High $288.40 | Professional | None (both parts) | $147.91 | $204.17 | $288.40 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None (both parts) | $208.93 | $208.93 | $208.93 |
22 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 $58.88 Median $64.57 Typical High $74.13 | Facility | 52 · Reduced service | $58.88 | $64.57 | $74.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $19.50 Typical High $21.88 | Facility | 55 · Aftercare only | $17.78 | $19.50 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.88 Typical High $14.79 | Facility | 56 · Pre-op care only | $11.75 | $12.88 | $14.79 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $234.42 Median $239.88 Typical High $245.47 | Facility | AF · Specialist physician | $234.42 | $239.88 | $245.47 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $173.78 Median $181.97 Typical High $186.21 | Facility | HO · Master's level | $173.78 | $181.97 | $186.21 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $199.53 Median $204.17 Typical High $208.93 | Facility | TD · Registered nurse | $199.53 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $69.18 Typical High $97.72 | Professional | 52 · Reduced service | $58.88 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $20.89 Typical High $29.51 | Professional | 55 · Aftercare only | $17.78 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.80 Typical High $19.50 | Professional | 56 · Pre-op care only | $11.75 | $13.80 | $19.50 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $173.78 Median $204.17 Typical High $213.80 | Professional | 25 · Same-day visit | $173.78 | $204.17 | $213.80 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | GC · Resident with teaching physician | $173.78 | $173.78 | $173.78 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 26 · Professional part | $204.17 | $204.17 | $204.17 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $58.88 Median $66.07 Typical High $74.13 | Facility | 52 · Reduced service | $58.88 | $66.07 | $74.13 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $19.95 Typical High $21.88 | Facility | 55 · Aftercare only | $17.78 | $19.95 | $21.88 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.80 Typical High $14.79 | Facility | 56 · Pre-op care only | $11.75 | $13.80 | $14.79 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $234.42 Median $239.88 Typical High $245.47 | Facility | AF · Specialist physician | $234.42 | $239.88 | $245.47 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $173.78 Median $181.97 Typical High $186.21 | Facility | HO · Master's level | $173.78 | $181.97 | $186.21 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $199.53 Median $204.17 Typical High $208.93 | Facility | TD · Registered nurse | $199.53 | $204.17 | $208.93 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $426.58 Median $741.31 Typical High $851.14 | Professional | 25 · Same-day visit | $426.58 | $741.31 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $69.18 Typical High $89.13 | Professional | 52 · Reduced service | $58.88 | $69.18 | $89.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $20.89 Typical High $26.92 | Professional | 55 · Aftercare only | $17.78 | $20.89 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.80 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.75 | $13.80 | $18.20 |
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· 31st of 51
$200
AK $380AL $158
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.