How much rates vary
Facilitymedian $126 · 10th to 90th $89 to $398Professionalmedian $95 · 10th to 90th $69 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 $70.79 Median $85.11 Typical High $97.72 | Facility | None | $70.79 | $85.11 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $131.83 | Professional | None | $67.61 | $91.20 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $134.90 | Professional | None | $74.13 | $114.82 | $134.90 |
BCBS Texas Setting Facility Modifier None Typical Low $117.49 Median $269.15 Typical High $489.78 | Facility | None | $117.49 | $269.15 | $489.78 |
BCBS Texas Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $141.25 | Professional | None | $69.18 | $95.50 | $141.25 |
Baylor Scott & White Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $120.23 | Professional | None | $81.28 | $114.82 | $120.23 |
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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $151.36 | Professional | None | $70.79 | $97.72 | $151.36 |
Health Smart Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $181.97 | Professional | None | $117.49 | $138.04 | $181.97 |
Lucent Health Setting Professional Modifier None Typical Low $144.54 Median $724.44 Typical High $724.44 | Professional | None | $144.54 | $724.44 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $97.72 Typical High $134.90 | Facility | None | $70.79 | $97.72 | $134.90 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $141.25 | Professional | None | $67.61 | $91.20 | $141.25 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $100.00 | Professional | None | $51.29 | $74.13 | $100.00 |
Oscar Health Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $257.04 | Professional | None | $125.89 | $169.82 | $257.04 |
Providence Setting Facility Modifier None Typical Low $74.13 Median $100.00 Typical High $134.90 | Facility | None | $74.13 | $100.00 | $134.90 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $147.91 | Professional | None | $70.79 | $97.72 | $147.91 |
United Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $141.25 | Professional | None | $69.18 | $97.72 | $141.25 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
18 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 $33.88 Median $45.71 Typical High $54.95 | Professional | 52 · Reduced service | $33.88 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $13.49 Typical High $16.60 | Professional | 55 · Aftercare only | $10.00 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.12 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.76 | $9.12 | $10.96 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $100.00 Median $114.82 Typical High $125.89 | Professional | 25 · Same-day visit | $100.00 | $114.82 | $125.89 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 33 · Preventive service | $117.49 | $117.49 | $117.49 |
Ambetter Setting Professional Modifier AM · Physician, team member Typical Low $109.65 Median $123.03 Typical High $125.89 | Professional | AM · Physician, team member | $109.65 | $123.03 | $125.89 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $74.13 Median $74.13 Typical High $134.90 | Professional | GC · Resident with teaching physician | $74.13 | $74.13 | $134.90 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | Q6 · Substitute physician, paid per time | $125.89 | $125.89 | $125.89 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $95.50 Median $104.71 Typical High $123.03 | Professional | SA · Nurse practitioner | $95.50 | $104.71 | $123.03 |
Ambetter Setting Professional Modifier U1 · State-defined Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | U1 · State-defined | $100.00 | $100.00 | $100.00 |
Ambetter Setting Professional Modifier U7 · State-defined Typical Low $67.61 Median $117.49 Typical High $117.49 | Professional | U7 · State-defined | $67.61 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $91.20 Median $138.04 Typical High $281.84 | Professional | 25 · Same-day visit | $91.20 | $138.04 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $33.88 | $45.71 | $52.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $13.49 Typical High $15.49 | Professional | 55 · Aftercare only | $10.00 | $13.49 | $15.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.76 | $9.12 | $10.47 |
Moda Health Setting Professional Modifier SA · Nurse practitioner Typical Low $223.87 Median $223.87 Typical High $229.09 | Professional | SA · Nurse practitioner | $223.87 | $223.87 | $229.09 |
United Setting Professional Modifier G0 · Stroke telehealth Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | G0 · Stroke telehealth | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | GQ · Store-and-forward telehealth | $245.47 | $245.47 | $245.47 |
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
$95.50
AK $224DC $83.18
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.