How much rates vary
Facilitymedian $115 · 10th to 90th $47 to $257Professionalmedian $52 · 10th to 90th $38 to $93
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 $39.81 Median $47.86 Typical High $53.70 | Facility | None | $39.81 | $47.86 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $74.13 | Professional | None | $38.02 | $50.12 | $74.13 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $63.10 | Professional | None | $41.69 | $56.23 | $63.10 |
BCBS Texas Setting Facility Modifier None Typical Low $67.61 Median $154.88 Typical High $275.42 | Facility | None | $67.61 | $154.88 | $275.42 |
BCBS Texas Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $79.43 | Professional | None | $38.02 | $51.29 | $79.43 |
Baylor Scott & White Setting Professional Modifier None Typical Low $48.98 Median $50.12 Typical High $72.44 | Professional | None | $48.98 | $50.12 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $53.70 Typical High $87.10 | Professional | None | $38.90 | $53.70 | $87.10 |
Lucent Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $41.69 Median $58.88 Typical High $75.86 | Facility | None | $41.69 | $58.88 | $75.86 |
Moda Health Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $70.79 | Professional | None | $38.02 | $50.12 | $70.79 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $53.70 | Professional | None | $30.20 | $30.20 | $53.70 |
Oscar Health Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $138.04 | Professional | None | $70.79 | $95.50 | $138.04 |
Providence Setting Facility Modifier None Typical Low $41.69 Median $63.10 Typical High $75.86 | Facility | None | $41.69 | $63.10 | $75.86 |
Providence Setting Professional Modifier None Typical Low $38.02 Median $53.70 Typical High $87.10 | Professional | None | $38.02 | $53.70 | $87.10 |
United Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $79.43 | Professional | None | $38.90 | $54.95 | $79.43 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
8 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 $19.05 Median $25.12 Typical High $30.20 | Professional | 52 · Reduced service | $19.05 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.41 Typical High $9.12 | Professional | 55 · Aftercare only | $5.75 | $7.41 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.01 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.80 | $5.01 | $6.03 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $41.69 Median $79.43 Typical High $190.55 | Professional | 25 · Same-day visit | $41.69 | $79.43 | $190.55 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 33 · Preventive service | $63.10 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $25.12 Typical High $28.84 | Professional | 52 · Reduced service | $19.05 | $25.12 | $28.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.41 Typical High $8.71 | Professional | 55 · Aftercare only | $5.75 | $7.41 | $8.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.01 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.80 | $5.01 | $5.75 |
Where Texas sits
The same service costs 2.7 times more in Alaska than in Washington, DC. 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· 44th of 51
$52.48
AK $126DC $46.77
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.