How much rates vary
Facilitymedian $126 · 10th to 90th $89 to $380Professionalmedian $98 · 10th to 90th $68 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 $69.18 Median $83.18 Typical High $97.72 | Facility | None | $69.18 | $83.18 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $131.83 | Professional | None | $64.57 | $93.33 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $104.71 Typical High $125.89 | Professional | None | $102.33 | $104.71 | $125.89 |
BCBS Texas Setting Facility Modifier None Typical Low $117.49 Median $263.03 Typical High $478.63 | Facility | None | $117.49 | $263.03 | $478.63 |
BCBS Texas Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $144.54 | Professional | None | $67.61 | $97.72 | $144.54 |
Baylor Scott & White Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $123.03 | Professional | None | $100.00 | $117.49 | $123.03 |
Christus Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna 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 Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $151.36 | Professional | None | $69.18 | $100.00 | $151.36 |
Health Smart Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $177.83 | Professional | None | $120.23 | $138.04 | $177.83 |
Lucent Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $100.00 Typical High $134.90 | Facility | None | $70.79 | $100.00 | $134.90 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $134.90 | Professional | None | $64.57 | $93.33 | $134.90 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $117.49 | Professional | None | $67.61 | $97.72 | $117.49 |
Oscar Health Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $257.04 | Professional | None | $117.49 | $134.90 | $257.04 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $102.33 Typical High $138.04 | Facility | None | $72.44 | $102.33 | $138.04 |
Providence Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $151.36 | Professional | None | $69.18 | $97.72 | $151.36 |
United Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $141.25 | Professional | None | $67.61 | $97.72 | $141.25 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $32.36 Median $45.71 Typical High $56.23 | Professional | 52 · Reduced service | $32.36 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.80 Typical High $16.60 | Professional | 55 · Aftercare only | $9.77 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.33 Typical High $11.22 | Professional | 56 · Pre-op care only | $6.46 | $9.33 | $11.22 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $100.00 Median $120.23 Typical High $128.82 | Professional | 25 · Same-day visit | $100.00 | $120.23 | $128.82 |
Ambetter Setting Professional Modifier AM · Physician, team member Typical Low $120.23 Median $120.23 Typical High $123.03 | Professional | AM · Physician, team member | $120.23 | $120.23 | $123.03 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | EP · Child screening program | $120.23 | $120.23 | $120.23 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | GC · Resident with teaching physician | $72.44 | $72.44 | $72.44 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | Q6 · Substitute physician, paid per time | $120.23 | $120.23 | $120.23 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $61.66 Median $100.00 Typical High $100.00 | Professional | SA · Nurse practitioner | $61.66 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $97.72 Median $138.04 Typical High $398.11 | Professional | 25 · Same-day visit | $97.72 | $138.04 | $398.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $45.71 Typical High $53.70 | Professional | 52 · Reduced service | $32.36 | $45.71 | $53.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.80 Typical High $16.22 | Professional | 55 · Aftercare only | $9.77 | $13.80 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.33 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.46 | $9.33 | $10.72 |
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
$97.72
AK $229DC $81.28
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.