How much rates vary
Facilitymedian $98 · 10th to 90th $74 to $316Professionalmedian $93 · 10th to 90th $63 to $162
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 $77.62 Typical High $95.50 | Facility | None | $64.57 | $77.62 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $128.82 | Professional | None | $61.66 | $89.13 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $131.83 | Professional | None | $97.72 | $114.82 | $131.83 |
BCBS Texas Setting Facility Modifier None Typical Low $109.65 Median $245.47 Typical High $446.68 | Facility | None | $109.65 | $245.47 | $446.68 |
BCBS Texas Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $138.04 | Professional | None | $63.10 | $93.33 | $138.04 |
Baylor Scott & White Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $128.82 | Professional | None | $67.61 | $104.71 | $128.82 |
Christus Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $147.91 | Professional | None | $66.07 | $95.50 | $147.91 |
Health Smart Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $173.78 | Professional | None | $117.49 | $134.90 | $173.78 |
Lucent Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $95.50 Typical High $128.82 | Facility | None | $67.61 | $95.50 | $128.82 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $125.89 | Professional | None | $61.66 | $89.13 | $125.89 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $128.82 | Professional | None | $89.13 | $93.33 | $128.82 |
Oscar Health Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $251.19 | Professional | None | $117.49 | $154.88 | $251.19 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $102.33 Typical High $131.83 | Facility | None | $67.61 | $102.33 | $131.83 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $147.91 | Professional | None | $66.07 | $95.50 | $147.91 |
United Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $138.04 | Professional | None | $63.10 | $93.33 | $138.04 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
12 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 $30.90 Median $44.67 Typical High $53.70 | Professional | 52 · Reduced service | $30.90 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $13.18 Typical High $16.22 | Professional | 55 · Aftercare only | $9.33 | $13.18 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.91 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.17 | $8.91 | $10.72 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $97.72 Median $114.82 Typical High $123.03 | Professional | 25 · Same-day visit | $97.72 | $114.82 | $123.03 |
Ambetter Setting Professional Modifier AM · Physician, team member Typical Low $114.82 Median $117.49 Typical High $125.89 | Professional | AM · Physician, team member | $114.82 | $117.49 | $125.89 |
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 $57.54 Median $114.82 Typical High $117.49 | Professional | SA · Nurse practitioner | $57.54 | $114.82 | $117.49 |
Ambetter Setting Professional Modifier U7 · State-defined Typical Low $97.72 Median $97.72 Typical High $114.82 | Professional | U7 · State-defined | $97.72 | $97.72 | $114.82 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $131.83 Typical High $295.12 | Professional | 25 · Same-day visit | $95.50 | $131.83 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $44.67 Typical High $51.29 | Professional | 52 · Reduced service | $30.90 | $44.67 | $51.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $9.33 | $13.18 | $15.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.91 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.17 | $8.91 | $10.23 |
Where Texas sits
The same service costs 2.8 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· 41st of 51
$93.33
AK $219DC $77.62
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.