How much rates vary
Facilitymedian $275 · 10th to 90th $145 to $794Professionalmedian $155 · 10th to 90th $110 to $380
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 $104.71 Median $109.65 Typical High $181.97 | Facility | None | $104.71 | $109.65 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $199.53 | Professional | None | $107.15 | $154.88 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $162.18 | Professional | None | $114.82 | $134.90 | $162.18 |
BCBS Texas Setting Facility Modifier None Typical Low $223.87 Median $512.86 Typical High $912.01 | Facility | None | $223.87 | $512.86 | $912.01 |
BCBS Texas Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $407.38 | Professional | None | $208.93 | $245.47 | $407.38 |
Baylor Scott & White Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $165.96 | Professional | None | $154.88 | $162.18 | $165.96 |
Christus Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $263.03 | Professional | None | $112.20 | $131.83 | $263.03 |
Health Smart Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $234.42 | Professional | None | $144.54 | $186.21 | $234.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $109.65 Typical High $239.88 | Facility | None | $104.71 | $109.65 | $239.88 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $213.80 | Professional | None | $107.15 | $154.88 | $213.80 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $151.36 | Professional | None | $81.28 | $114.82 | $151.36 |
Oscar Health Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $138.04 | Professional | None | $117.49 | $138.04 | $138.04 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $204.17 Typical High $263.03 | Facility | None | $158.49 | $204.17 | $263.03 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $263.03 | Professional | None | $112.20 | $131.83 | $263.03 |
United Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $269.15 | Professional | None | $128.82 | $173.78 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
23 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 $51.29 Median $53.70 Typical High $54.95 | Facility | 52 · Reduced service | $51.29 | $53.70 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $16.22 Typical High $16.60 | Facility | 55 · Aftercare only | $15.49 | $16.22 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $10.96 | Facility | 56 · Pre-op care only | $10.47 | $10.72 | $10.96 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $177.83 Median $181.97 Typical High $190.55 | Facility | AF · Specialist physician | $177.83 | $181.97 | $190.55 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $131.83 Median $134.90 Typical High $177.83 | Facility | HO · Master's level | $131.83 | $134.90 | $177.83 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $151.36 Median $154.88 Typical High $199.53 | Facility | TD · Registered nurse | $151.36 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $53.70 Typical High $70.79 | Professional | 52 · Reduced service | $51.29 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.22 Typical High $21.38 | Professional | 55 · Aftercare only | $15.49 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $14.45 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 25 · Same-day visit | $134.90 | $134.90 | $154.88 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $134.90 Median $134.90 Typical High $239.88 | Professional | 57 · Decision for surgery | $134.90 | $134.90 | $239.88 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $114.82 Median $138.04 Typical High $239.88 | Professional | FS · Shared visit | $114.82 | $138.04 | $239.88 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $134.90 Median $141.25 Typical High $173.78 | Professional | GC · Resident with teaching physician | $134.90 | $141.25 | $173.78 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $51.29 Median $53.70 Typical High $54.95 | Facility | 52 · Reduced service | $51.29 | $53.70 | $54.95 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $16.22 Typical High $16.60 | Facility | 55 · Aftercare only | $15.49 | $16.22 | $16.60 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $10.96 | Facility | 56 · Pre-op care only | $10.47 | $10.72 | $10.96 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $177.83 Median $181.97 Typical High $234.42 | Facility | AF · Specialist physician | $177.83 | $181.97 | $234.42 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $131.83 Median $134.90 Typical High $177.83 | Facility | HO · Master's level | $131.83 | $134.90 | $177.83 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $151.36 Median $154.88 Typical High $199.53 | Facility | TD · Registered nurse | $151.36 | $154.88 | $199.53 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $53.70 Median $389.05 Typical High $575.44 | Professional | 25 · Same-day visit | $53.70 | $389.05 | $575.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $53.70 Typical High $69.18 | Professional | 52 · Reduced service | $51.29 | $53.70 | $69.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.22 Typical High $20.42 | Professional | 55 · Aftercare only | $15.49 | $16.22 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $13.49 |
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· 35th of 51
$155
AK $288AL $120
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.