How much rates vary
Facilitymedian $117 · 10th to 90th $78 to $339Professionalmedian $95 · 10th to 90th $62 to $148
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 $64.57 Median $87.10 Typical High $112.20 | Facility | None | $64.57 | $87.10 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $117.49 | Professional | None | $67.61 | $91.20 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $125.89 | Professional | None | $63.10 | $102.33 | $125.89 |
BCBS Texas Setting Facility Modifier None Typical Low $85.11 Median $213.80 Typical High $407.38 | Facility | None | $85.11 | $213.80 | $407.38 |
BCBS Texas Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $134.90 | Professional | None | $66.07 | $91.20 | $134.90 |
Baylor Scott & White Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $144.54 | Professional | None | $72.44 | $114.82 | $144.54 |
Christus Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
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 $69.18 Median $93.33 Typical High $141.25 | Professional | None | $69.18 | $93.33 | $141.25 |
Health Smart Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $120.23 | Facility | None | $114.82 | $114.82 | $120.23 |
Health Smart Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $181.97 | Professional | None | $95.50 | $131.83 | $181.97 |
Lucent Health Setting Professional Modifier None Typical Low $131.83 Median $691.83 Typical High $691.83 | Professional | None | $131.83 | $691.83 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $114.82 Typical High $346.74 | Facility | None | $69.18 | $114.82 | $346.74 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $125.89 | Professional | None | $67.61 | $93.33 | $125.89 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $107.15 Typical High $144.54 | Professional | None | $19.50 | $107.15 | $144.54 |
Oscar Health Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $263.03 | Professional | None | $81.28 | $134.90 | $263.03 |
Providence Setting Facility Modifier None Typical Low $70.79 Median $125.89 Typical High $181.97 | Facility | None | $70.79 | $125.89 | $181.97 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $138.04 | Professional | None | $67.61 | $93.33 | $138.04 |
United Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $93.33 | Facility | None | $69.18 | $69.18 | $93.33 |
United Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $128.82 | Professional | None | $61.66 | $87.10 | $128.82 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
42 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 $32.36 Median $38.02 Typical High $46.77 | Facility | 52 · Reduced service | $32.36 | $38.02 | $46.77 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $11.48 Typical High $14.13 | Facility | 55 · Aftercare only | $9.77 | $11.48 | $14.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.59 Typical High $9.33 | Facility | 56 · Pre-op care only | $6.46 | $7.59 | $9.33 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $112.20 Median $114.82 Typical High $117.49 | Facility | AF · Specialist physician | $112.20 | $114.82 | $117.49 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $83.18 Median $87.10 Typical High $87.10 | Facility | HO · Master's level | $83.18 | $87.10 | $87.10 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $93.33 Median $97.72 Typical High $100.00 | Facility | TD · Registered nurse | $93.33 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $43.65 Typical High $46.77 | Professional | 52 · Reduced service | $32.36 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.18 Typical High $14.13 | Professional | 55 · Aftercare only | $9.77 | $13.18 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.71 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.46 | $8.71 | $9.33 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $67.61 Median $93.33 Typical High $125.89 | Professional | AF · Specialist physician | $67.61 | $93.33 | $125.89 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $50.12 Median $70.79 Typical High $93.33 | Professional | HO · Master's level | $50.12 | $70.79 | $93.33 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $57.54 Median $79.43 Typical High $107.15 | Professional | TD · Registered nurse | $57.54 | $79.43 | $107.15 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $72.44 Median $114.82 Typical High $141.25 | Professional | 25 · Same-day visit | $72.44 | $114.82 | $141.25 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 93 · Audio-only telehealth | $70.79 | $70.79 | $70.79 |
Ambetter Setting Professional Modifier AM · Physician, team member Typical Low $114.82 Median $147.91 Typical High $147.91 | Professional | AM · Physician, team member | $114.82 | $147.91 | $147.91 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | FS · Shared visit | $75.86 | $75.86 | $75.86 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $70.79 Median $85.11 Typical High $117.49 | Professional | GC · Resident with teaching physician | $70.79 | $85.11 | $117.49 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | GE · Resident, primary care exception | $85.11 | $85.11 | $85.11 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | Q6 · Substitute physician, paid per time | $114.82 | $114.82 | $114.82 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $75.86 Median $104.71 Typical High $125.89 | Professional | SA · Nurse practitioner | $75.86 | $104.71 | $125.89 |
Ambetter Setting Professional Modifier TH · Pregnancy care Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | TH · Pregnancy care | $120.23 | $120.23 | $134.90 |
Ambetter Setting Professional Modifier U1 · State-defined Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | U1 · State-defined | $97.72 | $97.72 | $97.72 |
Moda Health Setting Facility Modifier 25 · Same-day visit Typical Low $251.19 Median $363.08 Typical High $870.96 | Facility | 25 · Same-day visit | $251.19 | $363.08 | $870.96 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $32.36 Median $38.02 Typical High $46.77 | Facility | 52 · Reduced service | $32.36 | $38.02 | $46.77 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $11.48 Typical High $14.13 | Facility | 55 · Aftercare only | $9.77 | $11.48 | $14.13 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.59 Typical High $9.33 | Facility | 56 · Pre-op care only | $6.46 | $7.59 | $9.33 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $112.20 Median $114.82 Typical High $117.49 | Facility | AF · Specialist physician | $112.20 | $114.82 | $117.49 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $83.18 Median $87.10 Typical High $87.10 | Facility | HO · Master's level | $83.18 | $87.10 | $87.10 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $93.33 Median $97.72 Typical High $100.00 | Facility | TD · Registered nurse | $93.33 | $97.72 | $100.00 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $64.57 Median $112.20 Typical High $218.78 | Professional | 25 · Same-day visit | $64.57 | $112.20 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $43.65 Typical High $46.77 | Professional | 52 · Reduced service | $32.36 | $43.65 | $46.77 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.18 Typical High $14.13 | Professional | 55 · Aftercare only | $9.77 | $13.18 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.71 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.46 | $8.71 | $9.33 |
Moda Health Setting Professional Modifier 57 · Decision for surgery Typical Low $66.07 Median $117.49 Typical High $346.74 | Professional | 57 · Decision for surgery | $66.07 | $117.49 | $346.74 |
Moda Health Setting Professional Modifier AF · Specialist physician Typical Low $67.61 Median $89.13 Typical High $125.89 | Professional | AF · Specialist physician | $67.61 | $89.13 | $125.89 |
Moda Health Setting Professional Modifier GC · Resident with teaching physician Typical Low $83.18 Median $138.04 Typical High $363.08 | Professional | GC · Resident with teaching physician | $83.18 | $138.04 | $363.08 |
Moda Health Setting Professional Modifier HO · Master's level Typical Low $50.12 Median $67.61 Typical High $93.33 | Professional | HO · Master's level | $50.12 | $67.61 | $93.33 |
Moda Health Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $95.50 Median $112.20 Typical High $131.83 | Professional | Q6 · Substitute physician, paid per time | $95.50 | $112.20 | $131.83 |
Moda Health Setting Professional Modifier SA · Nurse practitioner Typical Low $87.10 Median $128.82 Typical High $204.17 | Professional | SA · Nurse practitioner | $87.10 | $128.82 | $204.17 |
Moda Health Setting Professional Modifier TD · Registered nurse Typical Low $57.54 Median $75.86 Typical High $107.15 | Professional | TD · Registered nurse | $57.54 | $75.86 | $107.15 |
United Setting Professional Modifier G0 · Stroke telehealth Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | G0 · Stroke telehealth | $223.87 | $223.87 | $223.87 |
United Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | GQ · Store-and-forward telehealth | $223.87 | $223.87 | $223.87 |
Where Texas sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 32nd of 51
$95.50
AK $170AL $74.13
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.