How much rates vary
Facilitymedian $288 · 10th to 90th $288 to $288Professionalmedian $275 · 10th to 90th $51 to $1,905
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 $223.87 Median $269.15 Typical High $288.40 | Facility | None | $223.87 | $269.15 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $407.38 | Professional | None | $223.87 | $269.15 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $302.00 | Professional | None | $257.04 | $302.00 | $302.00 |
BCBS Texas Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $436.52 | Professional | None | $239.88 | $295.12 | $436.52 |
Baylor Scott & White Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $501.19 | Professional | None | $302.00 | $338.84 | $501.19 |
Christus Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $371.54 | Professional | None | $234.42 | $302.00 | $371.54 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,630.27 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $309.03 Typical High $794.33 | Facility | None | $223.87 | $309.03 | $794.33 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $407.38 | Professional | None | $223.87 | $269.15 | $407.38 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $245.47 Typical High $323.59 | Professional | None | $44.67 | $245.47 | $323.59 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $575.44 Typical High $707.95 | Professional | None | $316.23 | $575.44 | $707.95 |
Providence Setting Facility Modifier None Typical Low $269.15 Median $338.84 Typical High $416.87 | Facility | None | $269.15 | $338.84 | $416.87 |
Providence Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $371.54 | Professional | None | $234.42 | $302.00 | $371.54 |
United Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $354.81 | Professional | None | $181.97 | $239.88 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $112.20 Median $134.90 Typical High $173.78 | Professional | 52 · Reduced service | $112.20 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $53.70 Typical High $69.18 | Professional | 53 · Discontinued | $44.67 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $39.81 Typical High $52.48 | Professional | 55 · Aftercare only | $33.11 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.92 Typical High $34.67 | Professional | 56 · Pre-op care only | $22.39 | $26.92 | $34.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $134.90 Typical High $173.78 | Professional | 52 · Reduced service | $112.20 | $134.90 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $53.70 Typical High $69.18 | Professional | 53 · Discontinued | $44.67 | $53.70 | $69.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $39.81 Typical High $52.48 | Professional | 55 · Aftercare only | $33.11 | $39.81 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.92 Typical High $34.67 | Professional | 56 · Pre-op care only | $22.39 | $26.92 | $34.67 |
United Setting Professional Modifier G0 · Stroke telehealth Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | G0 · Stroke telehealth | $446.68 | $446.68 | $446.68 |
Where Texas sits
The same service costs 2.8 times more in Alaska than in New York. 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· 43rd of 51
$275
AK $661NY $234
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.