How much rates vary
Facilitymedian $138 · 10th to 90th $100 to $427Professionalmedian $107 · 10th to 90th $76 to $178
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 $77.62 Median $93.33 Typical High $107.15 | Facility | None | $77.62 | $93.33 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $147.91 | Professional | None | $74.13 | $102.33 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $138.04 | Professional | None | $109.65 | $128.82 | $138.04 |
BCBS Texas Setting Facility Modifier None Typical Low $131.83 Median $295.12 Typical High $537.03 | Facility | None | $131.83 | $295.12 | $537.03 |
BCBS Texas Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $154.88 | Professional | None | $75.86 | $107.15 | $154.88 |
Baylor Scott & White Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $134.90 | Professional | None | $112.20 | $128.82 | $134.90 |
Christus Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $165.96 | Professional | None | $79.43 | $109.65 | $165.96 |
Health Smart Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $213.80 | Professional | None | $134.90 | $158.49 | $213.80 |
Lucent Health Setting Professional Modifier None Typical Low $162.18 Median $812.83 Typical High $812.83 | Professional | None | $162.18 | $812.83 | $812.83 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $109.65 Typical High $147.91 | Facility | None | $79.43 | $109.65 | $147.91 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $154.88 | Professional | None | $74.13 | $102.33 | $154.88 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $85.11 Typical High $114.82 | Professional | None | $30.20 | $85.11 | $114.82 |
Oscar Health Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $281.84 | Professional | None | $128.82 | $147.91 | $281.84 |
Providence Setting Facility Modifier None Typical Low $81.28 Median $112.20 Typical High $151.36 | Facility | None | $81.28 | $112.20 | $151.36 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $165.96 | Professional | None | $79.43 | $109.65 | $165.96 |
United Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $154.88 | Professional | None | $75.86 | $107.15 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
15 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 $37.15 Median $50.12 Typical High $61.66 | Professional | 52 · Reduced service | $37.15 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.14 Typical High $18.20 | Professional | 55 · Aftercare only | $11.22 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.23 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.41 | $10.23 | $12.30 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $109.65 Median $131.83 Typical High $138.04 | Professional | 25 · Same-day visit | $109.65 | $131.83 | $138.04 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 33 · Preventive service | $131.83 | $131.83 | $131.83 |
Ambetter Setting Professional Modifier AM · Physician, team member Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | AM · Physician, team member | $109.65 | $109.65 | $109.65 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $81.28 Median $81.28 Typical High $104.71 | Professional | GC · Resident with teaching physician | $81.28 | $81.28 | $104.71 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | Q6 · Substitute physician, paid per time | $131.83 | $131.83 | $138.04 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $109.65 Median $112.20 Typical High $131.83 | Professional | SA · Nurse practitioner | $109.65 | $112.20 | $131.83 |
Ambetter Setting Professional Modifier U7 · State-defined Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | U7 · State-defined | $131.83 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $109.65 Median $181.97 Typical High $446.68 | Professional | 25 · Same-day visit | $109.65 | $181.97 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $50.12 Typical High $57.54 | Professional | 52 · Reduced service | $37.15 | $50.12 | $57.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.14 Typical High $17.38 | Professional | 55 · Aftercare only | $11.22 | $15.14 | $17.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.23 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.41 | $10.23 | $11.75 |
Moda Health Setting Professional Modifier SA · Nurse practitioner Typical Low $138.04 Median $144.54 Typical High $257.04 | Professional | SA · Nurse practitioner | $138.04 | $144.54 | $257.04 |
Where Texas sits
The same service costs 2.7 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· 45th of 51
$107
AK $251DC $93.33
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.