How much rates vary
Facilitymedian $282 · 10th to 90th $107 to $1,514Professionalmedian $107 · 10th to 90th $74 to $178
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 $87.10 Median $186.21 Typical High $4,466.84 | Facility | None | $87.10 | $186.21 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $151.36 | Professional | None | $85.11 | $97.72 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $177.83 | Professional | None | $83.18 | $97.72 | $177.83 |
BCBS Texas Setting Facility Modifier None Typical Low $151.36 Median $338.84 Typical High $602.56 | Facility | None | $151.36 | $338.84 | $602.56 |
BCBS Texas Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $169.82 | Professional | None | $85.11 | $102.33 | $169.82 |
Baylor Scott & White Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $389.05 | Professional | None | $104.71 | $138.04 | $389.05 |
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 $1,348.96 Median $2,398.83 Typical High $5,623.41 | Facility | None | $1,348.96 | $2,398.83 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $165.96 | Professional | None | $89.13 | $107.15 | $165.96 |
Health Smart Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $199.53 | Professional | None | $123.03 | $138.04 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $165.96 Median $1,174.90 Typical High $1,174.90 | Professional | None | $165.96 | $1,174.90 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $588.84 Typical High $4,265.80 | Facility | None | $95.50 | $588.84 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $154.88 | Professional | None | $85.11 | $97.72 | $154.88 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $107.15 Typical High $144.54 | Professional | None | $19.50 | $107.15 | $144.54 |
Oscar Health Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $302.00 | Professional | None | $112.20 | $204.17 | $302.00 |
Providence Setting Facility Modifier None Typical Low $97.72 Median $1,000.00 Typical High $5,623.41 | Facility | None | $97.72 | $1,000.00 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $165.96 | Professional | None | $89.13 | $107.15 | $165.96 |
United Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $158.49 | Professional | None | $89.13 | $114.82 | $158.49 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
13 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 Professional Modifier 52 · Reduced service Typical Low $42.66 Median $47.86 Typical High $53.70 | Professional | 52 · Reduced service | $42.66 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.13 Typical High $15.85 | Professional | 55 · Aftercare only | $12.59 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.55 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.51 | $9.55 | $10.72 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 24 · Unrelated visit after surgery | $100.00 | $100.00 | $100.00 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $97.72 Median $104.71 Typical High $162.18 | Professional | 25 · Same-day visit | $97.72 | $104.71 | $162.18 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | GC · Resident with teaching physician | $117.49 | $117.49 | $117.49 |
Moda Health Setting Facility Modifier 27 · Multiple hospital visits Typical Low $794.33 Median $851.14 Typical High $870.96 | Facility | 27 · Multiple hospital visits | $794.33 | $851.14 | $870.96 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $177.83 Typical High $446.68 | Professional | 25 · Same-day visit | $95.50 | $177.83 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $47.86 Typical High $50.12 | Professional | 52 · Reduced service | $42.66 | $47.86 | $50.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.13 Typical High $15.14 | Professional | 55 · Aftercare only | $12.59 | $14.13 | $15.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.55 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.51 | $9.55 | $10.00 |
United Setting Professional Modifier G0 · Stroke telehealth Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | G0 · Stroke telehealth | $251.19 | $251.19 | $251.19 |
United Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | GQ · Store-and-forward telehealth | $251.19 | $251.19 | $251.19 |
Where Texas sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 45th of 51
$107
AK $263NJ $97.72
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.