How much rates vary
Facilitymedian $102 · 10th to 90th $71 to $309Professionalmedian $79 · 10th to 90th $54 to $135
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 $56.23 Median $77.62 Typical High $81.28 | Facility | None | $56.23 | $77.62 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $109.65 | Professional | None | $52.48 | $77.62 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $114.82 | Professional | None | $85.11 | $100.00 | $114.82 |
BCBS Texas Setting Facility Modifier None Typical Low $93.33 Median $213.80 Typical High $380.19 | Facility | None | $93.33 | $213.80 | $380.19 |
BCBS Texas Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $117.49 | Professional | None | $53.70 | $79.43 | $117.49 |
Baylor Scott & White Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $102.33 | Professional | None | $67.61 | $97.72 | $102.33 |
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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $81.28 Typical High $117.49 | Professional | None | $56.23 | $81.28 | $117.49 |
Health Smart Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $323.59 | Professional | None | $95.50 | $114.82 | $323.59 |
Lucent Health Setting Professional Modifier None Typical Low $323.59 Median $616.60 Typical High $616.60 | Professional | None | $323.59 | $616.60 | $616.60 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $79.43 Typical High $112.20 | Facility | None | $56.23 | $79.43 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $109.65 | Professional | None | $52.48 | $77.62 | $109.65 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $100.00 | Professional | None | $66.07 | $77.62 | $100.00 |
Oscar Health Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $213.80 | Professional | None | $102.33 | $131.83 | $213.80 |
Providence Setting Facility Modifier None Typical Low $57.54 Median $79.43 Typical High $112.20 | Facility | None | $57.54 | $79.43 | $112.20 |
Providence Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $114.82 | Professional | None | $56.23 | $79.43 | $114.82 |
United Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $114.82 | Professional | None | $54.95 | $77.62 | $114.82 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $26.30 Median $38.02 Typical High $46.77 | Professional | 52 · Reduced service | $26.30 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $11.48 Typical High $13.80 | Professional | 55 · Aftercare only | $7.94 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.76 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.25 | $7.76 | $9.33 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $85.11 Median $97.72 Typical High $104.71 | Professional | 25 · Same-day visit | $85.11 | $97.72 | $104.71 |
Ambetter Setting Professional Modifier AM · Physician, team member Typical Low $87.10 Median $100.00 Typical High $114.82 | Professional | AM · Physician, team member | $87.10 | $100.00 | $114.82 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | EP · Child screening program | $95.50 | $100.00 | $100.00 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | SA · Nurse practitioner | $79.43 | $85.11 | $85.11 |
Ambetter Setting Professional Modifier U7 · State-defined Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | U7 · State-defined | $87.10 | $87.10 | $100.00 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $83.18 Median $109.65 Typical High $295.12 | Professional | 25 · Same-day visit | $83.18 | $109.65 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $38.02 Typical High $43.65 | Professional | 52 · Reduced service | $26.30 | $38.02 | $43.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $11.48 Typical High $13.18 | Professional | 55 · Aftercare only | $7.94 | $11.48 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.25 | $7.76 | $8.71 |
Moda Health Setting Professional Modifier SA · Nurse practitioner Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | SA · Nurse practitioner | $169.82 | $169.82 | $169.82 |
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· 40th of 51
$79.43
AK $186DC $64.57
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.