How much rates vary
Facilitymedian $110 · 10th to 90th $71 to $302Professionalmedian $89 · 10th to 90th $59 to $151
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 $60.26 Median $72.44 Typical High $91.20 | Facility | None | $60.26 | $72.44 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $120.23 | Professional | None | $57.54 | $85.11 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $138.04 | Professional | None | $93.33 | $109.65 | $138.04 |
BCBS Texas Setting Facility Modifier None Typical Low $95.50 Median $229.09 Typical High $407.38 | Facility | None | $95.50 | $229.09 | $407.38 |
BCBS Texas Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $131.83 | Professional | None | $58.88 | $89.13 | $131.83 |
Baylor Scott & White Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $114.82 | Professional | None | $91.20 | $107.15 | $114.82 |
Christus Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $134.90 | Professional | None | $61.66 | $91.20 | $134.90 |
Health Smart Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $158.49 | Professional | None | $107.15 | $128.82 | $158.49 |
Lucent Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $63.10 Median $91.20 Typical High $125.89 | Facility | None | $63.10 | $91.20 | $125.89 |
Moda Health Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $120.23 | Professional | None | $57.54 | $85.11 | $120.23 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $120.23 | Professional | None | $83.18 | $93.33 | $120.23 |
Oscar Health Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $239.88 | Professional | None | $112.20 | $144.54 | $239.88 |
Providence Setting Facility Modifier None Typical Low $63.10 Median $95.50 Typical High $125.89 | Facility | None | $63.10 | $95.50 | $125.89 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $131.83 | Professional | None | $61.66 | $89.13 | $131.83 |
United Setting Professional Modifier None Typical Low $58.88 Median $87.10 Typical High $128.82 | Professional | None | $58.88 | $87.10 | $128.82 |
Wellpoint Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
13 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 $28.84 Median $42.66 Typical High $51.29 | Professional | 52 · Reduced service | $28.84 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.88 Typical High $15.49 | Professional | 55 · Aftercare only | $8.71 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.51 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.75 | $8.51 | $10.23 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $93.33 Median $107.15 Typical High $117.49 | Professional | 25 · Same-day visit | $93.33 | $107.15 | $117.49 |
Ambetter Setting Professional Modifier AM · Physician, team member Typical Low $107.15 Median $109.65 Typical High $112.20 | Professional | AM · Physician, team member | $107.15 | $109.65 | $112.20 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $93.33 Median $107.15 Typical High $125.89 | Professional | SA · Nurse practitioner | $93.33 | $107.15 | $125.89 |
Ambetter Setting Professional Modifier U7 · State-defined Typical Low $93.33 Median $93.33 Typical High $109.65 | Professional | U7 · State-defined | $93.33 | $93.33 | $109.65 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $93.33 Median $154.88 Typical High $389.05 | Professional | 25 · Same-day visit | $93.33 | $154.88 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $42.66 Typical High $48.98 | Professional | 52 · Reduced service | $28.84 | $42.66 | $48.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.88 Typical High $14.45 | Professional | 55 · Aftercare only | $8.71 | $12.88 | $14.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.51 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.75 | $8.51 | $9.77 |
Moda Health Setting Professional Modifier AM · Physician, team member Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | AM · Physician, team member | $123.03 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | Q6 · Substitute physician, paid per time | $93.33 | $93.33 | $93.33 |
Where Texas sits
The same service costs 2.9 times more in Alaska than in Washington, DC. 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
$89.13
AK $204DC $70.79
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.