How much rates vary
Facilitymedian $170 · 10th to 90th $68 to $380Professionalmedian $76 · 10th to 90th $58 to $141
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 $58.88 Median $67.61 Typical High $79.43 | Facility | None | $58.88 | $67.61 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $67.61 Typical High $100.00 | Professional | None | $56.23 | $67.61 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $91.20 | Professional | None | $64.57 | $85.11 | $91.20 |
BCBS Texas Setting Facility Modifier None Typical Low $100.00 Median $229.09 Typical High $407.38 | Facility | None | $100.00 | $229.09 | $407.38 |
BCBS Texas Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $123.03 | Professional | None | $64.57 | $81.28 | $123.03 |
Baylor Scott & White Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $87.10 | Professional | None | $72.44 | $74.13 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $120.23 | Professional | None | $57.54 | $75.86 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Moda Health Setting Facility Modifier None Typical Low $61.66 Median $85.11 Typical High $104.71 | Facility | None | $61.66 | $85.11 | $104.71 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $67.61 Typical High $97.72 | Professional | None | $56.23 | $67.61 | $97.72 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $46.77 Typical High $58.88 | Professional | None | $30.20 | $46.77 | $58.88 |
Oscar Health Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $186.21 | Professional | None | $104.71 | $141.25 | $186.21 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $85.11 Typical High $107.15 | Facility | None | $61.66 | $85.11 | $107.15 |
Providence Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $120.23 | Professional | None | $57.54 | $74.13 | $120.23 |
United Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $114.82 | Professional | None | $58.88 | $77.62 | $114.82 |
Wellpoint Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
9 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 $28.18 Median $33.88 Typical High $40.74 | Professional | 52 · Reduced service | $28.18 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.23 Typical High $12.30 | Professional | 55 · Aftercare only | $8.32 | $10.23 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.76 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.62 | $6.76 | $8.32 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 24 · Unrelated visit after surgery | $85.11 | $85.11 | $85.11 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 25 · Same-day visit | $89.13 | $89.13 | $89.13 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 33 · Preventive service | $44.67 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $33.88 Typical High $39.81 | Professional | 52 · Reduced service | $28.18 | $33.88 | $39.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.23 Typical High $12.02 | Professional | 55 · Aftercare only | $8.32 | $10.23 | $12.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.76 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.62 | $6.76 | $8.13 |
Where Texas sits
The same service costs 2.9 times more in Alaska than in Florida. 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· 39th of 51
$77.62
AK $186FL $64.57
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.