How much rates vary
Facilitymedian $162 · 10th to 90th $151 to $257Professionalmedian $151 · 10th to 90th $98 to $204
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 $131.83 Median $151.36 Typical High $181.97 | Facility | None | $131.83 | $151.36 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $181.97 | Professional | None | $134.90 | $151.36 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $169.82 | Professional | None | $112.20 | $144.54 | $169.82 |
BCBS Texas Setting Facility Modifier None Typical Low $398.11 Median $1,122.02 Typical High $1,122.02 | Facility | None | $398.11 | $1,122.02 | $1,122.02 |
BCBS Texas Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $194.98 | Professional | None | $97.72 | $138.04 | $194.98 |
Baylor Scott & White Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $223.87 | Professional | None | $162.18 | $199.53 | $223.87 |
Christus Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $199.53 | Professional | None | $61.66 | $100.00 | $199.53 |
Health Smart Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $263.03 | Professional | None | $186.21 | $229.09 | $263.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,230.27 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $181.97 Typical High $323.59 | Facility | None | $131.83 | $181.97 | $323.59 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $181.97 | Professional | None | $134.90 | $151.36 | $181.97 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $194.98 Typical High $218.78 | Professional | None | $34.67 | $194.98 | $218.78 |
Oscar Health Setting Facility Modifier None Typical Low $457.09 Median $851.14 Typical High $851.14 | Facility | None | $457.09 | $851.14 | $851.14 |
Oscar Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $194.98 | Professional | None | $147.91 | $147.91 | $194.98 |
Providence Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $257.04 | Facility | None | $181.97 | $181.97 | $257.04 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $194.98 | Professional | None | $61.66 | $100.00 | $194.98 |
United Setting Facility Modifier None Typical Low $269.15 Median $281.84 Typical High $371.54 | Facility | None | $269.15 | $281.84 | $371.54 |
United Setting Professional Modifier None Typical Low $144.54 Median $147.91 Typical High $194.98 | Professional | None | $144.54 | $147.91 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
19 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 AF · Specialist physician Typical Low $177.83 Median $181.97 Typical High $186.21 | Facility | AF · Specialist physician | $177.83 | $181.97 | $186.21 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $131.83 Median $134.90 Typical High $138.04 | Facility | HO · Master's level | $131.83 | $134.90 | $138.04 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $151.36 Median $151.36 Typical High $158.49 | Facility | TD · Registered nurse | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $109.65 Median $158.49 Typical High $181.97 | Professional | AF · Specialist physician | $109.65 | $158.49 | $181.97 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $134.90 Median $134.90 Typical High $138.04 | Professional | HO · Master's level | $134.90 | $134.90 | $138.04 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $54.95 Median $85.11 Typical High $151.36 | Professional | TD · Registered nurse | $54.95 | $85.11 | $151.36 |
Ambetter Setting Professional Modifier AF · Specialist physician Typical Low $131.83 Median $131.83 Typical High $162.18 | Professional | AF · Specialist physician | $131.83 | $131.83 | $162.18 |
Ambetter Setting Professional Modifier FQ · Audio-only Typical Low $107.15 Median $134.90 Typical High $134.90 | Professional | FQ · Audio-only | $107.15 | $134.90 | $134.90 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $125.89 Median $125.89 Typical High $154.88 | Professional | GC · Resident with teaching physician | $125.89 | $125.89 | $154.88 |
Ambetter Setting Professional Modifier HA · Child/adolescent program Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | HA · Child/adolescent program | $125.89 | $125.89 | $125.89 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | Q6 · Substitute physician, paid per time | $190.55 | $190.55 | $190.55 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $112.20 Median $134.90 Typical High $199.53 | Professional | SA · Nurse practitioner | $112.20 | $134.90 | $199.53 |
Ambetter Setting Professional Modifier U7 · State-defined Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | U7 · State-defined | $128.82 | $134.90 | $134.90 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $177.83 Median $181.97 Typical High $186.21 | Facility | AF · Specialist physician | $177.83 | $181.97 | $186.21 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $131.83 Median $134.90 Typical High $138.04 | Facility | HO · Master's level | $131.83 | $134.90 | $138.04 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $151.36 Median $151.36 Typical High $158.49 | Facility | TD · Registered nurse | $151.36 | $151.36 | $158.49 |
Moda Health Setting Professional Modifier AF · Specialist physician Typical Low $109.65 Median $158.49 Typical High $181.97 | Professional | AF · Specialist physician | $109.65 | $158.49 | $181.97 |
Moda Health Setting Professional Modifier HO · Master's level Typical Low $134.90 Median $134.90 Typical High $138.04 | Professional | HO · Master's level | $134.90 | $134.90 | $138.04 |
Moda Health Setting Professional Modifier TD · Registered nurse Typical Low $54.95 Median $79.43 Typical High $151.36 | Professional | TD · Registered nurse | $54.95 | $79.43 | $151.36 |
Where Texas sits
The same service costs 2.2 times more in North Dakota than in Kentucky. 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· 33rd of 51
$151
ND $295KY $132
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.