How much rates vary
Facilitymedian $79 · 10th to 90th $43 to $240Professionalmedian $60 · 10th to 90th $35 to $91
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 $38.02 Median $58.88 Typical High $70.79 | Facility | None | $38.02 | $58.88 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $83.18 | Professional | None | $38.90 | $61.66 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $72.44 Typical High $85.11 | Professional | None | $34.67 | $72.44 | $85.11 |
BCBS Texas Setting Facility Modifier None Typical Low $56.23 Median $141.25 Typical High $269.15 | Facility | None | $56.23 | $141.25 | $269.15 |
BCBS Texas Setting Professional Modifier None Typical Low $38.02 Median $56.23 Typical High $87.10 | Professional | None | $38.02 | $56.23 | $87.10 |
Baylor Scott & White Setting Facility Modifier None Typical Low $47.86 Median $147.91 Typical High $177.83 | Facility | None | $47.86 | $147.91 | $177.83 |
Baylor Scott & White Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $104.71 | Professional | None | $72.44 | $81.28 | $104.71 |
Christus Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $218.78 | Facility | None | $125.89 | $151.36 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $61.66 Typical High $93.33 | Professional | None | $39.81 | $61.66 | $93.33 |
Health Smart Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $81.28 | Facility | None | $66.07 | $66.07 | $81.28 |
Health Smart Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $288.40 | Professional | None | $79.43 | $89.13 | $288.40 |
Lucent Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $40.74 Median $72.44 Typical High $281.84 | Facility | None | $40.74 | $72.44 | $281.84 |
Moda Health Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $83.18 | Professional | None | $38.90 | $61.66 | $83.18 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $53.70 Typical High $72.44 | Professional | None | $9.77 | $53.70 | $72.44 |
Oscar Health Setting Professional Modifier None Typical Low $46.77 Median $79.43 Typical High $158.49 | Professional | None | $46.77 | $79.43 | $158.49 |
Providence Setting Facility Modifier None Typical Low $41.69 Median $89.13 Typical High $173.78 | Facility | None | $41.69 | $89.13 | $173.78 |
Providence Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $93.33 | Professional | None | $39.81 | $60.26 | $93.33 |
United Setting Facility Modifier None Typical Low $48.98 Median $63.10 Typical High $63.10 | Facility | None | $48.98 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $87.10 | Professional | None | $38.90 | $58.88 | $87.10 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
34 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 52 · Reduced service Typical Low $19.05 Median $22.39 Typical High $30.20 | Facility | 52 · Reduced service | $19.05 | $22.39 | $30.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $6.76 Typical High $9.12 | Facility | 55 · Aftercare only | $5.75 | $6.76 | $9.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.47 Typical High $6.03 | Facility | 56 · Pre-op care only | $3.80 | $4.47 | $6.03 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $77.62 Median $81.28 Typical High $83.18 | Facility | AF · Specialist physician | $77.62 | $81.28 | $83.18 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $58.88 Median $61.66 Typical High $61.66 | Facility | HO · Master's level | $58.88 | $61.66 | $61.66 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $66.07 Median $69.18 Typical High $70.79 | Facility | TD · Registered nurse | $66.07 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $28.18 Typical High $30.20 | Professional | 52 · Reduced service | $19.05 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $8.51 Typical High $9.12 | Professional | 55 · Aftercare only | $5.75 | $8.51 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.62 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.80 | $5.62 | $6.03 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $57.54 Median $81.28 Typical High $91.20 | Professional | AF · Specialist physician | $57.54 | $81.28 | $91.20 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $42.66 Median $61.66 Typical High $67.61 | Professional | HO · Master's level | $42.66 | $61.66 | $67.61 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $48.98 Median $69.18 Typical High $77.62 | Professional | TD · Registered nurse | $48.98 | $69.18 | $77.62 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $61.66 Median $72.44 Typical High $77.62 | Professional | 25 · Same-day visit | $61.66 | $72.44 | $77.62 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $35.48 Median $40.74 Typical High $40.74 | Professional | 93 · Audio-only telehealth | $35.48 | $40.74 | $40.74 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $40.74 Median $83.18 Typical High $83.18 | Professional | GC · Resident with teaching physician | $40.74 | $83.18 | $83.18 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | GP · Physical therapy plan | $72.44 | $72.44 | $72.44 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | Q6 · Substitute physician, paid per time | $75.86 | $75.86 | $75.86 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $72.44 Median $72.44 Typical High $74.13 | Professional | SA · Nurse practitioner | $72.44 | $72.44 | $74.13 |
Ambetter Setting Professional Modifier U7 · State-defined Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | U7 · State-defined | $72.44 | $72.44 | $72.44 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $19.05 Median $24.55 Typical High $30.20 | Facility | 52 · Reduced service | $19.05 | $24.55 | $30.20 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $7.41 Typical High $9.12 | Facility | 55 · Aftercare only | $5.75 | $7.41 | $9.12 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.90 Typical High $6.03 | Facility | 56 · Pre-op care only | $3.80 | $4.90 | $6.03 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $77.62 Median $81.28 Typical High $83.18 | Facility | AF · Specialist physician | $77.62 | $81.28 | $83.18 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $58.88 Median $61.66 Typical High $61.66 | Facility | HO · Master's level | $58.88 | $61.66 | $61.66 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $66.07 Median $69.18 Typical High $70.79 | Facility | TD · Registered nurse | $66.07 | $69.18 | $70.79 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $45.71 Median $77.62 Typical High $141.25 | Professional | 25 · Same-day visit | $45.71 | $77.62 | $141.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $28.18 Typical High $30.20 | Professional | 52 · Reduced service | $19.05 | $28.18 | $30.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $8.51 Typical High $9.12 | Professional | 55 · Aftercare only | $5.75 | $8.51 | $9.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.62 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.80 | $5.62 | $6.03 |
Moda Health Setting Professional Modifier AF · Specialist physician Typical Low $44.67 Median $81.28 Typical High $87.10 | Professional | AF · Specialist physician | $44.67 | $81.28 | $87.10 |
Moda Health Setting Professional Modifier HO · Master's level Typical Low $33.11 Median $61.66 Typical High $64.57 | Professional | HO · Master's level | $33.11 | $61.66 | $64.57 |
Moda Health Setting Professional Modifier TD · Registered nurse Typical Low $38.02 Median $69.18 Typical High $74.13 | Professional | TD · Registered nurse | $38.02 | $69.18 | $74.13 |
United Setting Professional Modifier G0 · Stroke telehealth Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | G0 · Stroke telehealth | $154.88 | $154.88 | $154.88 |
United Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | GQ · Store-and-forward telehealth | $154.88 | $154.88 | $154.88 |
Where Texas sits
The same service costs 2.2 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· 37th of 51
$60.26
AK $107NJ $48.98
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.