How much rates vary
Facilitymedian $120 · 10th to 90th $89 to $380Professionalmedian $93 · 10th to 90th $68 to $158
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 $67.61 Median $83.18 Typical High $95.50 | Facility | None | $67.61 | $83.18 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $125.89 | Professional | None | $64.57 | $89.13 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $123.03 | Professional | None | $97.72 | $114.82 | $123.03 |
BCBS Texas Setting Facility Modifier None Typical Low $112.20 Median $257.04 Typical High $478.63 | Facility | None | $112.20 | $257.04 | $478.63 |
BCBS Texas Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $138.04 | Professional | None | $67.61 | $93.33 | $138.04 |
Baylor Scott & White Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $117.49 | Professional | None | $85.11 | $112.20 | $117.49 |
Christus Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $147.91 | Professional | None | $69.18 | $95.50 | $147.91 |
Health Smart Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $186.21 | Professional | None | $117.49 | $141.25 | $186.21 |
Lucent Health Setting Professional Modifier None Typical Low $151.36 Median $724.44 Typical High $724.44 | Professional | None | $151.36 | $724.44 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $95.50 Typical High $131.83 | Facility | None | $70.79 | $95.50 | $131.83 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $134.90 | Professional | None | $64.57 | $89.13 | $134.90 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $117.49 | Professional | None | $69.18 | $97.72 | $117.49 |
Oscar Health Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $251.19 | Professional | None | $123.03 | $165.96 | $251.19 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $97.72 Typical High $131.83 | Facility | None | $72.44 | $97.72 | $131.83 |
Providence Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $147.91 | Professional | None | $69.18 | $95.50 | $147.91 |
United Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $138.04 | Professional | None | $67.61 | $93.33 | $138.04 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $44.67 Typical High $53.70 | Professional | 52 · Reduced service | $32.36 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.49 Typical High $16.22 | Professional | 55 · Aftercare only | $9.77 | $13.49 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.91 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.46 | $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 33 · Preventive service Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 33 · Preventive service | $128.82 | $128.82 | $128.82 |
Ambetter Setting Professional Modifier AM · Physician, team member Typical Low $100.00 Median $114.82 Typical High $151.36 | Professional | AM · Physician, team member | $100.00 | $114.82 | $151.36 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | EP · Child screening program | $114.82 | $114.82 | $114.82 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $93.33 Median $114.82 Typical High $114.82 | Professional | SA · Nurse practitioner | $93.33 | $114.82 | $114.82 |
Ambetter Setting Professional Modifier U7 · State-defined Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | U7 · State-defined | $114.82 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $93.33 Median $134.90 Typical High $281.84 | Professional | 25 · Same-day visit | $93.33 | $134.90 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $44.67 Typical High $51.29 | Professional | 52 · Reduced service | $32.36 | $44.67 | $51.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.49 Typical High $15.14 | Professional | 55 · Aftercare only | $9.77 | $13.49 | $15.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.91 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.46 | $8.91 | $10.23 |
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· 41st of 51
$93.33
AK $219DC $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.